{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:32:03Z","timestamp":1787063523206,"version":"build-2736575974"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,4,1]]},"abstract":"<jats:p>OBJECTIVES. For a cohort of extremely premature, ventilated, newborn infants, we determined the power of either serial caretaker intuitions of \u201cdie before discharge\u201d or serial illness severity scores to predict the outcomes of death in the NICU or neurologic performance at corrected age of 2 years.<\/jats:p>\n                  <jats:p>METHODS. We identified 268 premature infants who were admitted to our NICU in 1999\u20132004 and required mechanical ventilation. For each infant on each day of mechanical ventilation, we asked nurses, residents, fellows, and attending physicians the following question: \u201cDo you think this child is going to live to go home or die before hospital discharge?\u201d In addition, we calculated illness severity scores until either death or extubation.<\/jats:p>\n                  <jats:p>RESULTS. A total of 17066 intuition profiles were obtained on 5609 days of mechanical ventilation in the NICU. One hundred (37%) of 268 profiled infants had \u22651 intuition of die before discharge. Only 33 infants (33%) with an intuition of die actually died in the NICU. Of 48 infants with even 1 day of corroborated intuition of die in the NICU, only 7 (14%) were alive with both Mental Developmental Index and Psychomotor Developmental Index scores of &amp;gt;69, and only 2 (4%) were alive with both Mental Developmental Index and Psychomotor Developmental Index Scores of &amp;gt;79 at corrected age of 2 years. On day of life 1, the Score for Neonatal Acute Physiology II value for nonsurvivors (38.2 \u00b1 18.1) was significantly higher than that for survivors (26.3 \u00b1 12.7). However, this difference decreased steadily over time as scores improved for both groups.<\/jats:p>\n                  <jats:p>CONCLUSIONS. Illness severity scores become progressively less helpful over time in distinguishing infants who will either die in the NICU or survive with low Mental Developmental Index\/Psychomotor Developmental Index scores. Serial caretaker intuitions of die before discharge also fail to identify prospective nonsurviving infants. However, corroborated intuitions of die before discharge identify a subset of infants whose likelihood of surviving to 2 years with both MDI and PDI &amp;gt;80 is approximately 4%.<\/jats:p>","DOI":"10.1542\/peds.2006-2797","type":"journal-article","created":{"date-parts":[[2008,4,1]],"date-time":"2008-04-01T16:25:58Z","timestamp":1207067158000},"page":"732-740","source":"Crossref","is-referenced-by-count":64,"title":["Just, in Time: Ethical Implications of Serial Predictions of Death and Morbidity for Ventilated Premature Infants"],"prefix":"10.1542","volume":"121","author":[{"given":"William","family":"Meadow","sequence":"first","affiliation":[{"name":"Department of Pediatrics"},{"name":"MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Lagatta","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bree","family":"Andrews","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Caldarelli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaris","family":"Keiser","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Laporte","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Plesha-Troyke","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhu","family":"Subramanian","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Hron","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nima","family":"Golchin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,4,1]]},"reference":[{"key":"2021120902131491700_R1","doi-asserted-by":"crossref","unstructured":"Hack M, Fanaroff AA. 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