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Cuidados paliativos peri e neonatais : revisão bibliográfica a propósito de um caso clínico
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Cuidados paliativos peri e neonatais (CPPN) são cuidados de saúde holísticos e dinâmicos, que envolvem uma equipa multidisciplinar. A sua abordagem é centrada no feto/recém-nascido (RN) e sua família, devendo estes cuidados estar disponíveis em todos os casos de doença limitadora de vida ou potencialmente fatal (LV/PF). O seu objetivo é garantir a melhor qualidade de vida possível para os RN e respetivas famílias, tendo em vista medidas fundamentais como o alívio da dor e outros sintomas, apoio emocional, psicológico e espiritual. Estas medidas devem estar presente desde o diagnóstico, evolução da doença, em fim de vida, após a morte e durante o luto.
Apresenta-se o caso clínico de um recém-nascido do sexo feminino, no qual foi diagnosticado trissomia 18, após o nascimento, sendo esta uma patologia com indicação para CPPN. Após discussão com a mãe, foram iniciadas medidas de conforto e excluídas terapêuticas fúteis.
Em CPPN é importante uma comunicação clara e permanente entre a equipa de saúde e com os familiares, envolvendo-os no planeamento e incentivando-os a participar nos cuidados, criando memórias que os vão ajudar a lidar de forma mais saudável com o luto.
Peri and neonatal palliative care is holistic and dynamic care, involving a multidisciplinary team. Its approach is focused on the newborns and their families, and it should be available to all cases of limited live time or life-threatening illness. Its purpose is to ensure the best possible quality of life for the newborns and their families, considering fundamental measures such as relief of pain and other symptoms and emotional, psychological and spiritual support. These measures should be present throughout the progression of the disease, end of life, after death and during grief. It is reported the case of a female newborn, who was diagnosed Trisomy 18, after birth, which is a disease with indication for peri and neonatal palliative care. After discussion with the mother, comfort measures were decided and futile therapeutics excluded. In peri and neonatal palliative care is important a clear and constant communication between the health care team and the family involving them in the planning of medical care and encouraging them to be present, participate in care, and create memories that will help deal more healthily with grief.
Peri and neonatal palliative care is holistic and dynamic care, involving a multidisciplinary team. Its approach is focused on the newborns and their families, and it should be available to all cases of limited live time or life-threatening illness. Its purpose is to ensure the best possible quality of life for the newborns and their families, considering fundamental measures such as relief of pain and other symptoms and emotional, psychological and spiritual support. These measures should be present throughout the progression of the disease, end of life, after death and during grief. It is reported the case of a female newborn, who was diagnosed Trisomy 18, after birth, which is a disease with indication for peri and neonatal palliative care. After discussion with the mother, comfort measures were decided and futile therapeutics excluded. In peri and neonatal palliative care is important a clear and constant communication between the health care team and the family involving them in the planning of medical care and encouraging them to be present, participate in care, and create memories that will help deal more healthily with grief.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Cuidados paliativos Assistência perinatal Morte perinatal Luto