End-of-life decisions in delivery room and neonatal intensive care unit

2005 ◽  
Vol 94 (11) ◽  
pp. 1626-1631 ◽  
Author(s):  
Romaine Arlettaz ◽  
Dieto Mieth ◽  
Hans-Ulrich Bucher ◽  
Gabriel Duc ◽  
Jean-Claude Fauchère
Sensors ◽  
2021 ◽  
Vol 21 (3) ◽  
pp. 999
Author(s):  
Henry Dore ◽  
Rodrigo Aviles-Espinosa ◽  
Zhenhua Luo ◽  
Oana Anton ◽  
Heike Rabe ◽  
...  

Heart rate monitoring is the predominant quantitative health indicator of a newborn in the delivery room. A rapid and accurate heart rate measurement is vital during the first minutes after birth. Clinical recommendations suggest that electrocardiogram (ECG) monitoring should be widely adopted in the neonatal intensive care unit to reduce infant mortality and improve long term health outcomes in births that require intervention. Novel non-contact electrocardiogram sensors can reduce the time from birth to heart rate reading as well as providing unobtrusive and continuous monitoring during intervention. In this work we report the design and development of a solution to provide high resolution, real time electrocardiogram data to the clinicians within the delivery room using non-contact electric potential sensors embedded in a neonatal intensive care unit mattress. A real-time high-resolution electrocardiogram acquisition solution based on a low power embedded system was developed and textile embedded electrodes were fabricated and characterised. Proof of concept tests were carried out on simulated and human cardiac signals, producing electrocardiograms suitable for the calculation of heart rate having an accuracy within ±1 beat per minute using a test ECG signal, ECG recordings from a human volunteer with a correlation coefficient of ~ 87% proved accurate beat to beat morphology reproduction of the waveform without morphological alterations and a time from application to heart rate display below 6 s. This provides evidence that flexible non-contact textile-based electrodes can be embedded in wearable devices for assisting births through heart rate monitoring and serves as a proof of concept for a complete neonate electrocardiogram monitoring system.


Author(s):  
Vincent C. Smith

The author is an African American neonatologist who has worked in a neonatal intensive care unit (NICU) for the past twenty years. Despite belief systems being unique and diverse, he believes they serve an important role in society, especially in the context of NICU care. In this chapter, the author attempts to describe what he considers to be some salient points about being a provider in the NICU and the role that a family’s belief system plays in critical and end-of-life care for their newborn. He tries to emphasize how belief systems are complex and personal.


2004 ◽  
Vol 52 (Suppl 1) ◽  
pp. S97.1-S97
Author(s):  
K. Yaeger ◽  
A. Murphy ◽  
K. Braccia ◽  
M. Coyle ◽  
J. Anderson ◽  
...  

2019 ◽  
Vol 34 (3) ◽  
pp. 430-434 ◽  
Author(s):  
Laure Dombrecht ◽  
Joachim Cohen ◽  
Filip Cools ◽  
Luc Deliens ◽  
Linde Goossens ◽  
...  

Background: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. Aim: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient. Design/participants: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support. Results: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support. Conclusion: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.


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