Experience with newborn intensive care deaths in a tertiary setting

The purpose of this paper is to report the longitudinal experience with dea ths in a United States' newborn intensive care unit. Retrospective analysis comparing infant deaths in two epochs: Epoch 1: 1985-1988 (n = 127) and Ep och 2: 1991-1994 (n = 75). Data included demographic factors, age at death, episodes of cardiopulmonary resuscitation, do not resuscitate status, and whether withdrawal of support occurred. Infants in Epoch 2 were significant ly younger at birth (28.7 +/- 0.7 vs. 30.6 +/- 0.5 wks', p = 0.02) and deat h (31.5 +/- 0.9 vs. 34.0 +/- 0.7 wks', p = 0.02) than those in Epoch 1. The re was no difference in length of stay (19.5 +/- 5.1 vs. 24.4 +/- 4.2 days, Epoch 2 vs. Epoch 1). Infants were more likely to receive cardiopulmonary resuscitation in Epoch 2 than Epoch 1 (60 vs. 41%, p = 0.008). However, mor e infants in Epoch 2 also had do not resuscitate status (80% vs. 59%, p = 0 .002) or withdrawal of support (72% vs. 52%, p = 0.005). The majority of ne wborn intensive care deaths currently occur with do not resuscitate status and/or withdrawal of support.