A participação do enfermeiro na limitação de suporte de vida em pacientes internados em unidades de tratamento intensivo pediátrico de dois hospitais universitários do sul do Brasil

• Autor(a) principal: Nilson, Cristine
• Data de Publicação: 2009
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional PUCRS
• Texto Completo: http://hdl.handle.net/10923/4681
• topic: MEDICINA; ÉTICA MÉDICA; RESSUSCITAÇÃO CARDIOPULMONAR; UNIDADES DE TERAPIA INTENSIVA PEDIÁTRICA; DOENTE TERMINAL; MORTE

Objective: To evaluate the medical practices in the last 24 hours of life of children who died in 2 Brazilian Pediatric Intensive Care Unit (PICU) as well as observe the nurse’s participation on the end of life decision´s. Setting: A cross-sectional, observational study enrolling children that died between April and September/2008 in two Brazilian PICU. Four researches were trained to fulfill 3 protocols looking for information regarding the interventions provided in the last 24 hours of life and the nurse’s participations on life support limitation decision. The Student t test, ANOVA, chi-square, Kruskal-Wallis and Mann-Whitney were used for comparison of data. Results: 37 deaths were identified, 3 cases of brain death were excluded. In 50% of death cardiopulmonary resuscitation (CPR) was not performed. The decision of life support limitation was not recorded in the medical charts in 58% (10/17) of patients who were not reanimated. In more than 80% patients that CPR was not performed, inotropic drugs infusion and ventilator parameters were maintained or increased without differences between the two groups, CPR and no CPR (p=1,0 and p=0,6). The nurse’s practices in the last 24 hours of life didn’t show any differences even when the patient was defined as having terminal disease. Conclusion: Brazilian studies have been demonstrated that end-of-life of terminal patients was a stressful process, centralized on medical approaches, without family participations. This study shows the same practices with a low contribution of the nurses in the decision making process.