Publication
Establishing a Neonatal Palliative Care Program in a Tertiary Level Neonatal Intensive Care Unit
Mascarenhas D, Goyal M, Raghavendra P, Raman R, Talawadekar P, Muckaden M, Deodhar J, Nanavati R, Haribalakrishna A · Indian journal of pediatrics · 2025
Objectives To describe the planning and implementation of the neonatal palliative care (NPC) program in the neonatal intensive care unit (NICU) in a major referral hospital in western India. Methods The authors describe the neonatal characteristics, components of NPC care delivered and outcomes, along with barriers and enablers of the program. This was a retrospective, single-center observational study conducted in a level IIIB NICU from December 2021 to December 2022. Results Two hundred and sixty-six neonates were enrolled and 65 (24.4%) received NPC, of which 33 (50.8%) were enrolled at admission and 32 (49.2%) were re-directed from critical care towards palliation. The median enrollment was at 2 d of life. The most common conditions for initiating palliative care were severe sepsis with multi-organ dysfunction, complex congenital heart diseases and severe hypoxic-ischemic encephalopathy. For minimizing pain, all received non-pharmacological measures, however 8 (12.31%) additionally received pharmacological agents. The majority received enteral feeding during palliation (66.15%), frequently with the mother’s milk (93.02%). Nearly three-fourths (76.92%) were ventilated, with 90% of them receiving invasive ventilation. Memorabilia including footprints, photographs or infant personalized items were accepted by 53 families (81.53%). One hundred and nineteen (44.74%) neonates died, and bereavement support was extended to 113 (95%) of them. Conclusions Parallel care model integrating NPC in NICU settings is achievable in collaboration with pioneering centers. This model helps support a large number of neonates in high-burden NICUs ensuring early initiation of NPC.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.