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

The terms palliative care, supportive care, and comfort care are used to describe individualized care that can provide a dying person the best quality of life until the end. The term [end-of-life care] is also used in a general sense to refer to all aspects of care of a patient with a potentially fatal condition. While the concept of palliative care is not new, it has only recently been applied to the neonatal population. To the best of our knowledge, none of the neonatal intensive care units [NICUs] in Saudi Arabia have adopted a neonatal program for palliative care. We believe the main reason is lack of knowledge of such programs and the fear of being accused of being heartless and cruel by providing comfort care for dying babies. Comfort care begins with the diagnosis of a life-threatening/terminal condition, and continues throughout the course of illness regardless of the outcome. In this prespective, our aim is to introduce these programs for caregivers in the NICUs in Saudi Arabia. For this purpose, we have reviewed the current recommendations in establishing neonatal palliative care programs and discussed some of the social and religious aspects pertaining to this issue

Right-sided hydrothorax: a complication of umbilical venous catheterization

Umbilical venous catheters [UVC] are still used occasionally for fluid infusion in newborn infants. Although many complications have been reported, hydrothorax rarely occurs. We report a premature infant who developed right-sided hydrothorax due to fluid infusion through a malpositioned UVC

Fiberoptic, conventional and combination phototherapy for treatment of nonhemolytic hyperbilirubinemia in neonates

The objective of this prospective, randomized study was to compare the effectiveness of fiberoptic, conventional and a combination phototherapy in decreasing bilirubin concentrations in neonatal nonhemolytic hyperbilirubinemia. Forty-six infants who were 36 weeks' gestation and more were randomly assigned to fiberoptic phototherapy [n=16] [Biliblanket, Ohmeda], conventional daylight phototherapy [n=15] and combination phototherapy [n=15] [fiberoptic and conventional]. The groups were similar in clinical characteristics at study entry in terms of birth weight, age and bilirubin concentration. There were no statistically significant differences in the duration of treatment among the three groups [P=0.83]. There were also no statistically significant differences among the three groups in the serum bilirubin concentrations at 24 hours, 48 hours, end of phototherapy, and 24 hours postphototherapy. We conclude that the decrease in serum bilirubin concentration was comparable among fiberoptic, conventional and combination phototherapy groups