Abstract
The Austrian recommendations for the management of extremely preterm infants at the border of viability were last updated in 2017 and initially recommended a primarily palliative approach in gestational week 220-6 due to extremely low survival rates. Since then data from various countries and institutions have shown significantly improved survival rates in this gestational week of over 50% in specialized centers. The updated recommendations reflect these new findings and the advances in neonatal intensive care. The most significant change from the previous version is the expansion of the "gray zone" from week 230-6 to weeks 22+0-23+6, based on the recent literature. The importance of antenatal transfer to only few specialized centers and the practice of shared decision making, where parents are involved in the decision process, is emphasized. The recommendations address ethical, legal and medical aspects and offer individual guidance for the postnatal management of extremely preterm infants born at 220-6, 230-6, and 240-6 weeks of gestation. The goal is to provide a framework for responsible decision-making that considers the best interests of the child, while incorporating the latest medical data, and ensuring that parents are fully involved in the process.
| Titel in Übersetzung | Recommendations for the care of extremely premature infants at the border of viability: Joint recommendations of the Working Group Neonatology and Pediatric Intensive Care (AG NPI) of the Austrian Society for Pediatrics and Adolescent Medicine (ÖGKJ) and the Institute for Ethics and Law in Medicine of the University of Vienna (IERM) updated 2024 |
|---|---|
| Originalsprache | Deutsch |
| Seitenumfang | 9 |
| Fachzeitschrift | Monatsschrift Kinderheilkunde |
| DOIs | |
| Publikationsstatus | Veröffentlicht - Okt. 2024 |
Schlagwörter
- 22 weeks gestational age
- Border of Viability
- Extremely Preterm Infant
- Neonatal Intensive Care
- Shared Decision Making
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Berger, A., Simma, B., Kiechl-Kohlendorfer, U., Urlesberger, B., Wald, M., Wald, M., Csillag, B., Badinger-Sobotka, B., Salzer, H., & Kletecka-Pulker, M. (2024). Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024. Monatsschrift Kinderheilkunde. https://doi.org/10.1007/s00112-024-02066-9
Berger, Angelika ; Simma, Burkhard ; Kiechl-Kohlendorfer, Ursula et al. / Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit : Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024. in: Monatsschrift Kinderheilkunde. 2024.
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title = "Empfehlung zur Versorgung von Fr{\"u}hgeborenen an der Grenze der Lebensf{\"a}higkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und P{\"a}diatrische Intensivmedizin (AG NPI) der {\"O}GKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der {\"O}GKJ und des Instituts f{\"u}r Ethik und Recht in der Medizin der Universit{\"a}t Wien (IERM), aktualisiert 2024",
abstract = "The Austrian recommendations for the management of extremely preterm infants at the border of viability were last updated in 2017 and initially recommended a primarily palliative approach in gestational week 220-6 due to extremely low survival rates. Since then data from various countries and institutions have shown significantly improved survival rates in this gestational week of over 50% in specialized centers. The updated recommendations reflect these new findings and the advances in neonatal intensive care. The most significant change from the previous version is the expansion of the {"}gray zone{"} from week 230-6 to weeks 22+0-23+6, based on the recent literature. The importance of antenatal transfer to only few specialized centers and the practice of shared decision making, where parents are involved in the decision process, is emphasized. The recommendations address ethical, legal and medical aspects and offer individual guidance for the postnatal management of extremely preterm infants born at 220-6, 230-6, and 240-6 weeks of gestation. The goal is to provide a framework for responsible decision-making that considers the best interests of the child, while incorporating the latest medical data, and ensuring that parents are fully involved in the process.",
keywords = "22 weeks gestational age, Border of Viability, Extremely Preterm Infant, Neonatal Intensive Care, Shared Decision Making",
author = "Angelika Berger and Burkhard Simma and Ursula Kiechl-Kohlendorfer and Berndt Urlesberger and Martin Wald and Martin Wald and Bernhard Csillag and Barbara Badinger-Sobotka and Hans Salzer and Maria Kletecka-Pulker",
note = "Wald: Division f{\"u}r Neonatologie, Universit{\"a}tsklinik f{\"u}r Kinder- und Jugendheilkunde, Paracelsus Medizinische Privatuniversit{\"a}t, Salzburg, {\"O}sterreich",
year = "2024",
month = oct,
doi = "10.1007/s00112-024-02066-9",
language = "Deutsch",
journal = "Monatsschrift Kinderheilkunde",
issn = "0026-9298",
publisher = "Springer Nature",
}
Berger, A, Simma, B, Kiechl-Kohlendorfer, U, Urlesberger, B, Wald, M, Wald, M, Csillag, B, Badinger-Sobotka, B, Salzer, H & Kletecka-Pulker, M 2024, 'Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024', Monatsschrift Kinderheilkunde. https://doi.org/10.1007/s00112-024-02066-9
Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024. / Berger, Angelika; Simma, Burkhard; Kiechl-Kohlendorfer, Ursula et al.
in: Monatsschrift Kinderheilkunde, 10.2024.
Publikation: Beitrag in Fachzeitschrift › Übersichtsarbeit › Begutachtung
TY - JOUR
T1 - Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit
T2 - Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024
AU - Berger, Angelika
AU - Simma, Burkhard
AU - Kiechl-Kohlendorfer, Ursula
AU - Urlesberger, Berndt
AU - Wald, Martin
AU - Wald, Martin
AU - Csillag, Bernhard
AU - Badinger-Sobotka, Barbara
AU - Salzer, Hans
AU - Kletecka-Pulker, Maria
N1 - Wald: Division für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Paracelsus Medizinische Privatuniversität, Salzburg, Österreich
PY - 2024/10
Y1 - 2024/10
N2 - The Austrian recommendations for the management of extremely preterm infants at the border of viability were last updated in 2017 and initially recommended a primarily palliative approach in gestational week 220-6 due to extremely low survival rates. Since then data from various countries and institutions have shown significantly improved survival rates in this gestational week of over 50% in specialized centers. The updated recommendations reflect these new findings and the advances in neonatal intensive care. The most significant change from the previous version is the expansion of the "gray zone" from week 230-6 to weeks 22+0-23+6, based on the recent literature. The importance of antenatal transfer to only few specialized centers and the practice of shared decision making, where parents are involved in the decision process, is emphasized. The recommendations address ethical, legal and medical aspects and offer individual guidance for the postnatal management of extremely preterm infants born at 220-6, 230-6, and 240-6 weeks of gestation. The goal is to provide a framework for responsible decision-making that considers the best interests of the child, while incorporating the latest medical data, and ensuring that parents are fully involved in the process.
AB - The Austrian recommendations for the management of extremely preterm infants at the border of viability were last updated in 2017 and initially recommended a primarily palliative approach in gestational week 220-6 due to extremely low survival rates. Since then data from various countries and institutions have shown significantly improved survival rates in this gestational week of over 50% in specialized centers. The updated recommendations reflect these new findings and the advances in neonatal intensive care. The most significant change from the previous version is the expansion of the "gray zone" from week 230-6 to weeks 22+0-23+6, based on the recent literature. The importance of antenatal transfer to only few specialized centers and the practice of shared decision making, where parents are involved in the decision process, is emphasized. The recommendations address ethical, legal and medical aspects and offer individual guidance for the postnatal management of extremely preterm infants born at 220-6, 230-6, and 240-6 weeks of gestation. The goal is to provide a framework for responsible decision-making that considers the best interests of the child, while incorporating the latest medical data, and ensuring that parents are fully involved in the process.
KW - 22 weeks gestational age
KW - Border of Viability
KW - Extremely Preterm Infant
KW - Neonatal Intensive Care
KW - Shared Decision Making
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001336398500001&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s00112-024-02066-9
DO - 10.1007/s00112-024-02066-9
M3 - Übersichtsarbeit
SN - 0026-9298
JO - Monatsschrift Kinderheilkunde
JF - Monatsschrift Kinderheilkunde
ER -
Berger A, Simma B, Kiechl-Kohlendorfer U, Urlesberger B, Wald M, Wald M et al. Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024. Monatsschrift Kinderheilkunde. 2024 Okt. doi: 10.1007/s00112-024-02066-9
