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体外膜肺氧合治疗儿童的伦理考量

Ethical Considerations for Care of the Child Undergoing Extracorporeal Membrane Oxygenation.

作者信息

Carter Martha A

出版信息

AORN J. 2017 Feb;105(2):148-158. doi: 10.1016/j.aorn.2016.12.001.

Abstract

Extracorporeal membrane oxygenation (ECMO) is a complex, highly technical surgical procedure that can offer hope for children born with congenital heart defects. The procedure may only briefly prolong a life, has limited potential for decreasing mortality, and may lead to serious complications, however. Perioperative nurses play an important role in caring for the child who requires ECMO. They are involved in assessing the child, implementing the plan of care, and facilitating communication between the child's family members and the health care team. Thus, perioperative nurses have a responsibility to consider the broad range of ethical issues associated with the procedure. By examining the ethical concepts of beneficence, nonmaleficence, autonomy, justice, and moral distress, the perioperative nurse can better understand the dilemmas that can affect the care and outcome of the critically ill child who requires ECMO.

摘要

体外膜肺氧合(ECMO)是一种复杂、技术要求很高的外科手术,可为患有先天性心脏缺陷的儿童带来希望。然而,该手术可能只能短暂延长生命,降低死亡率的潜力有限,还可能导致严重并发症。围手术期护士在护理需要ECMO的儿童方面发挥着重要作用。他们参与评估患儿、实施护理计划,并促进患儿家庭成员与医疗团队之间的沟通。因此,围手术期护士有责任考虑与该手术相关的广泛伦理问题。通过审视行善、不伤害、自主、公正和道德困扰等伦理概念,围手术期护士能更好地理解可能影响需要ECMO的危重症患儿护理及预后的困境。

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