Opinions of paediatricians who teach neonatal resuscitation about resuscitation practices on extremely preterm infants in the delivery room

dc.contributor.authorAmbrosio, Cristiane Ribeiro [UNIFESP]
dc.contributor.authorSanudo, Adriana [UNIFESP]
dc.contributor.authorMartinez, Alma M.
dc.contributor.authorAlmeida, Maria Fernanda Branco de [UNIFESP]
dc.contributor.authorGuinsburg, Ruth [UNIFESP]
dc.description.abstractObjective To describe the opinions of paediatricians who teach resuscitation in Brazil regarding resuscitation practices in the delivery room (DR) of preterm infants with gestational ages of 23-26 weeks. Methods Cross-sectional study with an internationally validated electronic questionnaire (December 2011-September 2013) sent to the instructors of the Neonatal Resuscitation Program of the Brazilian Society of Paediatrics on parental counselling practices, medical limits for resuscitation of extremely preterm infants and medical considerations for decision-making in this group of infants. The analysis was descriptive. Results Among 685 instructors, 560 (82%) agreed to participate. Only 5%-13% reported having opportunity for antenatal counselling parents: if called, 22% reported discussing with the family about the possibility not to resuscitate in the DRen
dc.description.abstract63% about the possibility of death in the DR and 89% about the possibility of death in the neonatal unit. If the parents did not agree with the advice of the paediatrician, 30%-50% of the respondents would follow the procedures they advised regardless of the opinion of the parents. The higher the gestational age, the lower is the percentage of paediatricians who believed that parents should participate in decision-making. Only 9% participants reported the existence of written guidelines at their hospital on initiation of resuscitation in the DR at limits of viability, but 80% paediatricians reported using some criteria for limiting resuscitation in the DR. Conclusion The picture obtained in this study of Brazilian paediatricians indicates that resuscitation of extremely preterm infants is permeated by ambivalence and contradictions.en
dc.description.affiliationUniv Fed Sao Paulo, Div Neonatal Med, Dept Pediat, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Uberlandia, Dept Pediat, Uberlandia, MG, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Preventat Med, Sao Paulo, Brazil
dc.description.affiliationUniv Calif San Francisco, San Francisco, CA 94143 USA
dc.description.affiliationUnifespDivision of Neonatal Medicine, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.affiliationUnifespDepartment of Preventative Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.identifier.citationJournal Of Medical Ethics. London, v. 42, n. 11, p. 725-728, 2016.
dc.publisherBmj Publishing Group
dc.relation.ispartofJournal Of Medical Ethics
dc.rightsAcesso restrito
dc.titleOpinions of paediatricians who teach neonatal resuscitation about resuscitation practices on extremely preterm infants in the delivery roomen