Putting futility to use in the NICU: ethical implications of non‐survival after CPR in very low‐birth‐weight infants

Cardiopulmonary Resuscitation and Epinephrine Infusion in Extremely Low Birth Weight Infants in the Neonatal Intensive Care Unit

“…The definitions we applied in this study for both CPR and the etiology of events leading to it were similar to previously published studies. 8,10 In contrast to reported data, 7,8,12 no difference in survival in relation to the event initiating CPR was demonstrated. Despite initial success in resuscitation, none of the infants in our study who received CPR survived to discharge.…”

“…4 Owing to the persistence of a high rate of disability accompanying increased survival rates in ELBW infants, questions regarding their optimal early acute management remain. [5][6][7][8] How long and how hard should the NICU team strive to achieve survival of these tiniest infants? 9,10 Should the substantial costs involved be a consideration in these decisions at all?…”

Survival of the Very-Low-Birth-Weight Infants after Cardiopulmonary Resuscitation in Neonatal Intensive Care Unit

“…The authors suggested considering CPR in the second category of the patients to be futile therapy asserting that their symptoms were highly predictive of nonsurvival and pretty often, clearly recognizable in advance. 6 Finer et al analyzed the outcome of delivery room CPR in VLBW infants and showed that majority of these infants survive, and at least half of such infants survived without severe neurological deficit. 7 In our study, two out of three infants who needed CPR only in the delivery room survived.…”

Successful Islet Transplantation for Patients with Diabetes — Fact or Fantasy?

“…Empirical research has been conducted about the effects on survival of a number of medical treatments, such as cardiopulmonary resuscitation, [18][19][20][21] pediatric and neonatal intensive care, 22,23 and intensive care for patients with hematologic cancers, 24 including patients undergoing bone marrow transplantation. 25 Such efforts improved physicians' ability to make accurate predictions about several homogeneous groups of patients.…”