Article Title

The ventilator-dependent infant requiring palliative care in the neonatal intensive care unit: A literature review


Aim: To review the literature relevant to palliative care of the ventilated infant and their family.

Background: Impeccable symptom assessment and management is necessary to ensure the optimal quality of life for the ventilated palliative infant and their family. There is a plethora of literature regarding symptom assessment and care when a decision has been made to withdraw ventilatory support. However, there is a lack of literature related to nursing practice for the palliated infant who remains dependent upon ventilatory support until death.

Data sources: CINAHL, PubMed, Elsevier and Proquest Health and Medical Compltete databases were searched (2000-2009).

Method: Seventeen articles were reviewed including: 10 research reports; three literature reviews; two discussion papers; one systematic review and one report documenting the development of a Paediatric palliative care programme.

Results: Best practice palliative care requires that care be planned and implemented by an expert multidisciplinary team in collaboration with the infant's parents who should participate in all levels of decision making to ensure optimal care. The need for impeccable symptom assessment was identified as a key factor in the provision of high-quality symptom control. The assumption regarding a paucity of literature surrounding the continuation of family-centred palliative care for those infants who remain on a ventilator until their death was supported.

Conclusion and relevance to clinical practice: Evidence-based recommendations highlighted in this review may be used as a starting point to formulate neonatal intensive care unit (NICU) clinical guidelines for family-centred palliative care of the ventilator-dependent infant.



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