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Integrating neurocritical care approaches into neonatology: should all infants be treated equitably?

Journal of Perinatology volume 35, pages 977–981 (2015)Cite this article

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Abstract

To improve the neurologic outcomes for infants with brain injury, neonatal providers are increasingly implementing neurocritical care approaches into clinical practice. Term infants with brain injury have been principal beneficiaries of neurologically-integrated care models to date, as evidenced by the widespread adoption of therapeutic hypothermia protocols for hypoxic-ischemic encephalopathy. Innovative therapeutic and diagnostic support for very low birth weight infants with brain injury has lagged behind. Given that concern for significant future neurodevelopmental impairment can lead to decisions to withdraw life supportive care at any gestational age, providing families with accurate prognostic information is essential for all infants. Current variable application of multidisciplinary neurocritical care approaches to infants at different gestational ages may be ethically problematic and reflect distinct perceptions of brain injury for infants born extremely premature.

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Acknowledgements

We thank Edward J. Novotny, Jr., MD, for his helpful comments regarding the manuscript. No funding was secured for this study. We have no financial relationships to disclose.

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Authors and Affiliations

  1. Department of Pediatrics, University of Washington, Seattle, WA, USA

    P C Mann, S M Gospe & B S Wilfond

  2. Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA, USA

    P C Mann & B S Wilfond

  3. Department of Neurology, University of Washington, Seattle, WA, USA

    S M Gospe & K J Steinman

  4. Division of Neurology, Seattle Children’s Hospital, Seattle, WA, USA

    S M Gospe & K J Steinman

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Mann, P., Gospe, S., Steinman, K. et al. Integrating neurocritical care approaches into neonatology: should all infants be treated equitably?. J Perinatol 35, 977–981 (2015). https://doi.org/10.1038/jp.2015.95

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