Characterization of Death in Neonatal Encephalopathy in the Hypothermia Era

Monica E. Lemmon, Renee D. Boss, Sonia L. Bonifacio, Audrey Foster-Barber, A. James Barkovich, Hannah C. Glass

Research output: Contribution to journalArticle

Abstract

This study aimed to characterize the circumstances of death in encephalopathic neonates treated with therapeutic hypothermia. Patients who died after or during treatment with therapeutic hypothermia between 2007-2014 were identified. Patient circumstance of death was characterized using an established paradigm. Thirty-one of 229 patients died (14%) at a median of 3 days of life. Most who died were severely encephalopathic on examination (90%) and had severely abnormal electroencephalographic (EEG) findings (87%). All those who had magnetic resonance images (n = 13) had evidence of moderate-severe brain injury; 6 had near-total brain injury. Cooling was discontinued prematurely in 61% of patients. Most patients (90%) were physiologically stable at the time of death; 81% died following elective extubation for quality of life considerations. Three patients (10%) died following withholding or removal of artificial hydration and nutrition. Characterization of death in additional cohorts is needed to identify differences in decision making practices over time and between centers.

Original languageEnglish (US)
Pages (from-to)360-365
Number of pages6
JournalJournal of child neurology
Volume32
Issue number4
DOIs
StatePublished - Mar 1 2017

Keywords

  • death
  • decision making
  • hypoxic-ischemic encephalopathy
  • neonatal encephalopathy
  • therapeutic hypothermia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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    Lemmon, M. E., Boss, R. D., Bonifacio, S. L., Foster-Barber, A., Barkovich, A. J., & Glass, H. C. (2017). Characterization of Death in Neonatal Encephalopathy in the Hypothermia Era. Journal of child neurology, 32(4), 360-365. https://doi.org/10.1177/0883073816681904