The need for hospital-based neonatal palliative care programs in Saudi Arabia

Palliative Care (PC) is still a relatively new concept in the Middle East (ME). It was first introduced in Saudi Arabia in 1992 and only recently in countries such as Qatar, Bahrain, and the UAE. Although the majority of Middle-Eastern countries, including Palestine, Iraq, Oman and Lebanon are in the capacity building phase, others such as Saudi and Jordan already have localized provision. In the absence of any of the ME countries approaching integration with the mainstream service providers, Saudi Arabia and Jordan are currently setting examples of achievement in the field. There are still countries with little or no known Palliative Care activity (Yemen and Syria). Political issues, scarcity of resources, and lack of education and awareness seem to be the common factors restricting the progress of this field in most countries. In order to improve the suboptimal PC services in the ME, emphasis should be directed toward providing formal education to professionals and raising awareness of the public. It is also necessary to put all differences aside and develop cross-border collaborations, whether through third party organizations such as the Middle East Cancer Consortium (MECC) or otherwise. This review compiles the available literature on the history and progress of the field of PC in most ME countries, while pointing out the major obstacles encountered by the active parties of each country.

show abstract

“…These programs are important to help children in the end-of-life situations and also to help their parents in these stressful events. 29…”

Section: Saudi Arabiamentioning

confidence: 99%

Middle East Experience in Palliative Care

Zeinah

Al‐Kindi

Hassan

2012

Am J Hosp Palliat Care

View full text Add to dashboard Cite

show abstract

“…Survival rate was very low at 23 weeks gestation, but it improved as GA advanced. The very low survival rate at 23 weeks could reflect our NICU staff’s attitude and treatment goals during this period [ 15 , 22 ]. At this gestational age, 13% of those infants received comfort care only at birth and in another 17% of infants active care was withheld.…”

Section: Discussionmentioning

confidence: 99%

Decisions and outcome for infants born near the limit of viability

Al-Hazzani

Alaiyan

Jabr

et al. 2021

International Journal of Pediatrics and Adolescent Medicine

View full text Add to dashboard Cite

Background Initiation or withholding life support at birth on infants born prematurely near the limit of viability is not an easy decision, with wide variation in practice around the world. Our aim was to review the outcome of preterm infants born near the limit of viability at 23–25 weeks gestation in our institution, with regard to resuscitation decision, survival, and major outcome measures. Methods We included all live newborn infants born prematurely at 23–25 weeks gestation at King Faisal Specialist Hospital and Research Centre from January 2006 to December 2015. We collected data on resuscitation decisions, survival, and major neonatal morbidities such as severe brain injury, severe retinopathy of prematurity, and bronchopulmonary dysplasia. Results Between January 1, 2006 and December 31, 2015, 97 infants with a gestational age (GA) of 23–25 weeks gestation were admitted; 23, 42, and 32 infants were born at 23, 24, and 25 weeks gestation, respectively. At 23 weeks gestation, full support was initiated in 87% of patients and later on support was withheld in 17.4% of patients, finally 13% of patients survived to discharge. At 24 weeks, full support was initiated in 97.6% of patients, then withheld in 7.1% of patients, and ultimately 59.5% survived. At 25 weeks, full support was initiated in 93.8% of patients, then withheld in 15.6% of patients, and ultimately 62.5% survived. In terms of survival with and without the three major neonatal morbidities, at 23 weeks gestation, no infant survived without any morbidity as compared to 7.1% and 28.1% at 24 and 25 weeks, respectively. The incidence of survival with 1 major morbidity was 8.7%, 30.9%, and 34.4% at 23, 24, and 25 weeks, respectively, the incidence of survival with 2 major morbidities was 0%, 19%, and 0% at 23, 24, and 25 weeks, respectively, and the incidence of survival with 3 major morbidities was 4.3%, 2.4%, and 0% at 23, 24, and 25 weeks, respectively. Conclusion In our patient cohort, survival and survival without major neonatal morbidity were very low at 23 weeks gestation, but it improved gradually as gestational age advanced.

show abstract

“…While suff ering can be viewed as a test of faith, analgesia is considered acceptable. Consultation with an imam may help the family with end-of-life decisions (Al-Alaiyan & Al-Hazzani, 2009;Sachedina, 2005).…”

Section: Judaismmentioning

confidence: 99%