Palliative Care in Neonatal Intensive Care Units for Extremely Low Birth-Weight Infants: Enhancing Quality of Life and Family-Centered Care.

BACKGROUND

Palliative care is an evolving methodology for managing patients' and their families' complex physiologic, social, emotional, and spiritual needs. While these practices have been extensively studied in adult populations, their context within the framework of pediatric and neonatal care is relatively new.

PURPOSE: The purpose of this manuscript is to examine current evidence on the use of palliative care management to enhance the quality of life of extremely low birth-weight infants within the neonatal intensive care unit.

METHODS

A comprehensive literature review of evidence-based research about extremely low birth-weight infants within the neonatal intensive care units and palliative care was conducted. After all abstracts were analyzed, 14 potentially relevant publications were selected and reviewed. Additional texts and articles were utilized for the pathophysiology framework and medical management recommendations for the various disease processes discussed.

RESULTS

Despite counseling that occurs to inform parents of potential complications associated with extreme prematurity, there remains a need for continued communication, support, and shared decision-making throughout the extremely low birth-weight infant's hospital course to improve family-centered care. Palliative care management is a resource that can aid in the short- and long-term management of the diagnoses received by these patients.

IMPLICATIONS FOR PRACTICE AND RESEARCH: Palliative care management and family-centered care, when utilized alongside the medical management of extremely low birth-weight infants, have the potential to improve outcomes and the quality of life for affected infants and their families. However, palliative care management in neonatology is a new and evolving field, and further research is necessary.