2021 Volume 57 Issue 3 Pages 434-440
Background: In Japan, neonatal palliative care has been focused in a few decades. We have tried to sophisticate the way how to cope with the neonates with LTI and get grief care for their families since fourteen years ago.
Subjects and Method: We reviewed retrospectively our 54 neonatal cases who have died at NICU for these fourteen years 2005.1-2018.12.
Results: Congenital anomaly 15 cases（27.8%）, ELBW26 cases（48.1%）, severe congenital heart disease 2 cases（3.7%）, HIE 6 cases（11.1%）, others 5 cases（9.3%）. 5 cases（9.3%）are dying at delivery room or operation room, 31 cases（57.4%）at NICU, 17cases（31.5%）surrounding by family room with family members, 1case（1.9%） at home. 17cases（31.5%）were using sedation. 9 cases（16.7%）was diagnosed before birth, and all of them Advanced Care Planning performed.
Discussion: Through these palliative care process, some family members could have gradually focus on the quality of life with their loved one in spite of their severe condition also in Japan. Our theme which we are confronting is the first of all we have no protocol of use medication for pain management for neonatal end-of-life care, the second, withdrawal of life support is not allowed under Japanese low, the third, education of life ethic for neonates with LTI.
Conclusion:We need to standardize Japanese protocol of palliative care to collect various experiences in other NICUs and compare with those in other countries.
