Most neonatal ICU deaths

The primary mode of infant death in a neonatal intensive care unit is withdrawing support and withholding lifesaving measures, U.S. researchers say. Dr. Julie Weiner of Children's Mercy Hospital in Kansas City, Mo., and colleagues examined medical records of 414 infants who died from January 1999 to December 2008 at a regional referral neonatal intensive care unit. "Currently, most U.S. childhood deaths occur during the neonatal period and most neonatal deaths follow a decision to withhold or withdraw life-sustaining treatment," the study authors said. Of the 414 infant deaths included in the study, 45 percent were due to major birth defects. Seventeen percent of these infants were very preterm and 35 percent of deaths were of very preterm births without congenital birth defects, the study said. The study, published in the Archives of Pediatrics & Adolescent Medicine, found during the 10-year follow-up period, 61.6 percent of infant deaths followed withdrawal of treatment, 20.8 percent followed withholding of treatment and 17.6 percent died despite attempted cardiopulmonary resuscitation. "During the 10-year period, the primary mode of death in this regional referral neonatal intensive care unit was withdrawal of life-sustaining support," the authors concluded. "Significant increase in withholding of care suggests improved recognition of medical futility and desire to provide a peaceful death."