Edward Goldson

Severe Bronchopulmonary Dysplasia in the Very Low Birth Weight Infant: Its Relationship to Developmental Outcome

The purpose of this study was to evaluate the developmental outcome of a group of very low birth weight children (VLBW) with and without severe bronchopulmonary dysplasia (BPD), at the time of discharge from the nursery. Children matched for birth weight and gestational age with mild or no BPD served as controls. All of the children were evaluated developmentally at two years of age, using the Bayley Scales of Infant Development. Neuromotor function was assessed by occupational and physical therapists. The data suggested that children with severe BPD performed more poorly on developmental testing and had a higher incidence of neuromotor pathology than did controls. However, the controls did manifest suspicious neuromotor findings. The data suggest that infants with BPD are not a homogeneous group. Very low birth weight infants, whether or not they have severe BPD, are at risk for having developmental delays. These infants should be closely monitored from the time of nursery discharge.

When Treatment Fails: How Medicine Cares for Dying Children

In addition to a discussion of questions surrounding whether to withhold or withdraw curative treatments, When Treatment Fails explores the crucial concerns of those medical practitioners who care for dying children: education and training, relation with one another, communicating with patients and families, and finally, coping and moving on. Ultimately, the threads connecting these themes are the great costs and rewards of this difficult work, and the lessons that can be drawn from the nitty-gritty experiences of medical practitioners who struggle to find the balance between trying to defeat death and trying to provide comfort.