Empfehlung zur Versorgung von Frühgeborenen an der Grenze der Lebensfähigkeit: Gemeinsame Empfehlung der Arbeitsgruppe Neonatologie und Pädiatrische Intensivmedizin (AG NPI) der ÖGKJ, der Arbeitsgruppe Ethik in der Kinder- und Jugendheilkunde (AG Ethik) der ÖGKJ und des Instituts für Ethik und Recht in der Medizin der Universität Wien (IERM), aktualisiert 2024

The Austrian recommendations for the management of extremely preterm infants at the border of viability were last updated in 2017 and initially recommended a primarily palliative approach in gestational week 22^0–6 due to extremely low survival rates. Since then data from various countries and institutions have shown significantly improved survival rates in this gestational week of over 50% in specialized centers. The updated recommendations reflect these new findings and the advances in neonatal intensive care. The most significant change from the previous version is the expansion of the “gray zone” from week 23^0–6 to weeks 22⁺⁰–23⁺⁶, based on the recent literature. The importance of antenatal transfer to only few specialized centers and the practice of shared decision making, where parents are involved in the decision process, is emphasized. The recommendations address ethical, legal and medical aspects and offer individual guidance for the postnatal management of extremely preterm infants born at 22^0–6, 23^0–6, and 24^0–6 weeks of gestation. The goal is to provide a framework for responsible decision-making that considers the best interests of the child, while incorporating the latest medical data, and ensuring that parents are fully involved in the process.