{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:56:32Z","timestamp":1784328992988,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,12,23]],"date-time":"2015-12-23T00:00:00Z","timestamp":1450828800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Occasional babies survive long term after withdrawal of intensive care despite a poor prognosis. We aimed to review in detail the clinical cases, characteristics, and outcomes of neonates with unexpected protracted survival following planned withdrawal of intensive cardiorespiratory support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed infants who unexpectedly survived for more than one week following planned withdrawal of intensive care in two tertiary\u2010level NICUs over a seven\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified eight long\u2010term survivors (six term, two preterm) between 2007 and 2013. All had a clinical diagnosis of grade 3 hypoxic\u2010ischaemic encephalopathy and severely abnormal electroencephalography and neuroimaging prior to intensive care withdrawal. Intensive care was withdrawn at five days postnatal age (range: two to nine days), but the possibility of protracted survival was discussed beforehand in only two cases. Three infants died before three months of age. Five infants remain alive, currently aged from 2.0 to 6.5 years, and all have significant neurodevelopmental problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Unexpected long\u2010term survival after neonatal intensive care withdrawal occurs occasionally but unpredictably. Significant neurodevelopmental adversity was invariable in those surviving beyond infancy. Ventilator dependency along with severely abnormal electroencephalography and neuroimaging is still compatible with long\u2010term survival. The possibility of protracted survival should be discussed routinely with parents before intensive care withdrawal.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.13279","type":"journal-article","created":{"date-parts":[[2015,11,24]],"date-time":"2015-11-24T14:39:00Z","timestamp":1448375940000},"page":"468-474","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Characteristics of babies who unexpectedly survive long term after withdrawal of intensive care"],"prefix":"10.1111","volume":"105","author":[{"given":"Sanchita","family":"Pal","sequence":"first","affiliation":[{"name":"Neonatal Unit Cambridge University Hospitals NHS Foundation Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Jones","sequence":"additional","affiliation":[{"name":"Neonatal Unit Norfolk &amp; Norwich University Hospitals NHS Foundation Trust Norwich Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajeev","family":"Job","sequence":"additional","affiliation":[{"name":"Neonatal Unit Norfolk &amp; Norwich University Hospitals NHS Foundation Trust Norwich Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Maynard","sequence":"additional","affiliation":[{"name":"East Anglia's Children's Hospices (EACH) Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Curley","sequence":"additional","affiliation":[{"name":"Neonatal Unit Cambridge University Hospitals NHS Foundation Trust Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Clarke","sequence":"additional","affiliation":[{"name":"Neonatal Unit Norfolk &amp; Norwich University Hospitals NHS Foundation Trust Norwich Norfolk UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.08.044"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.07.019"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0447"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-0916"},{"key":"e_1_2_12_6_1","volume-title":"Withholding or Withdrawing Life Sustaining Treatment in Children: a Framework for Practice, (2nd edition)","author":"Royal College of Paediatrics and Child Health","year":"2004"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2013-305845"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/fn.85.1.F8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-307399"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0413"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005237-200607000-00015"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2011.01.022"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9566.12020"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2011.4"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00364.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2005-0014"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-0780"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39273.604063.DB"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/fetalneonatal-2012-301658"},{"key":"e_1_2_12_20_1","unstructured":"SidenH.Prolonged survival frequent after withdrawal of neonatal nutrition and hydration (Abstract). 18th International Congress on Palliative Care Montreal Canada2010."},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2014-306666"}],"container-title":["Acta Paediatrica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapa.13279","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apa.13279","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T20:58:35Z","timestamp":1695761915000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apa.13279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,23]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,5]]}},"alternative-id":["10.1111\/apa.13279"],"URL":"https:\/\/doi.org\/10.1111\/apa.13279","archive":["Portico"],"relation":{},"ISSN":["0803-5253","1651-2227"],"issn-type":[{"value":"0803-5253","type":"print"},{"value":"1651-2227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12,23]]},"assertion":[{"value":"2015-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-11-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-12-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}