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Pediatric Palliative Care in Infants and Neonates

by Brian S. Carter 1,2,3
University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64108, USA
Children’s Mercy Hospital, Kansas City, MO 64108, USA
Division of Neonatology and Bioethics Center, 2401 Gillham Road, Kansas City, MO 64108, USA
Children 2018, 5(2), 21;
Received: 7 December 2017 / Revised: 24 January 2018 / Accepted: 1 February 2018 / Published: 7 February 2018
(This article belongs to the Special Issue Pediatric Palliative Care)
The application of palliative and hospice care to newborns in the neonatal intensive care unit (NICU) has been evident for over 30 years. This article addresses the history, current considerations, and anticipated future needs for palliative and hospice care in the NICU, and is based on recent literature review. Neonatologists have long managed the entirety of many newborns’ short lives, given the relatively high mortality rates associated with prematurity and birth defects, but their ability or willingness to comprehensively address of the continuum of interdisciplinary palliative, end of life, and bereavement care has varied widely. While neonatology service capacity has grown worldwide during this time, so has attention to pediatric palliative care generally, and neonatal-perinatal palliative care specifically. Improvements have occurred in family-centered care, communication, pain assessment and management, and bereavement. There remains a need to integrate palliative care with intensive care rather than await its application solely at the terminal phase of a young infant’s life—when s/he is imminently dying. Future considerations for applying neonatal palliative care include its integration into fetal diagnostic management, the developing era of genomic medicine, and expanding research into palliative care models and practices in the NICU. View Full-Text
Keywords: neonatal; palliative care; comfort care; pain neonatal; palliative care; comfort care; pain
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Carter, B.S. Pediatric Palliative Care in Infants and Neonates. Children 2018, 5, 21.

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