ArticleBMJ paediatrics open2025
Short-term outcomes of treatment limitation discussions in neonatal care units of tertiary care hospital in Karachi, Pakistan: a cross-sectional study.
Article in BMJ paediatrics open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Therapeutic potential and translational challenges of extracellular vesicles in neonatal medicine.Bioengineering & translational medicine · 2026Review
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine the short-term outcomes of treatment limitation discussions (TLDs) in neonates with life-limiting conditions and life-threatening conditions.
designDescriptive cross-sectional study. SETTINGS: The study was conducted at the neonatal care units of a single tertiary care hospital in Karachi, Pakistan. PATIENTS: Neonates for whom clinicians or parents considered TLDs were included in the study. The study duration was from May 2022 to May 2023.
interventionsNone.
main outcome measuresPrimary outcome was documented in the form of frequency of full code, withdrawal of life-sustaining support, and do not resuscitate (DNR) orders in neonates. The secondary outcome was categorised as discharge, death, transfer from the neonatal intensive care unit (NICU) to a step-down unit or leave against medical advice (LAMA).
resultsA total of 115 patients were included. Full code was documented in 14 patients (12.2%), withdrawal of life-sustaining support in 54 cases (47.0%) and DNR in 47 patients (40.9%). Of the 115 cases, 11 (9.6%) were discharged, 90 (78.3%) died, 7 (6.1%) were shifted out of the NICU and 7 (6.1%) LAMA. We found that 14 out of 115 parents (12.2%) chose the full code option despite clinicians advising withdrawal or DNR. Of those, 13 (92.8%) did not survive, and 1 (7.1%) was shifted out of the NICU.
conclusionsThe most frequent outcome after TLD was withdrawal of life-sustaining support. The majority of babies did not survive following TLD, irrespective of the code decided. Early transition out of the NICU was considered for babies with DNR orders.
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