Recently published UK guidelines suggest not:
Guidelines put forward by the council recommend that intensive care should not be given to babies born before 22 weeks and babies born between 22 and 23 weeks should not, in normal practice, be given intensive care unless parents make a request and doctors agree.
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Neonatologists are not the group to look to for leadership here. THey tend to view as a ’save’ anything that survives to discharge. While they do have their patients back to their clinic for a few months while transitioning care to the plain old pediatrician, they never follow up for years and decades.
There are many children alive and normally functioning as a result of modern neonatal developments. But there are all too many kids who keep rolling through our ORs completely devastated, with no cognitive function or scintilla of conscious functioning. The families were given enormous hopes and are now stuck with spastic, seizing, hydrocephalic and tube fed kids.
When weighing the efficacy of a therapy, short term outcomes, like survival to discharge, should be ignored, when long term outcomes are fully knowable for the population. In determining the full costs of resuscitation, the full cost of the worst failures must be included in the calculation.
I agree. Too many babies are saved when they shouldn’t be.
1% of people consume over 50% of the healthcare dollar. Where is the outrage?
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