University Of Ottawa, Ottawa, ON, Canada.
Pediatric Palliative Care Program, Children's Hospital of Eastern Ontario and Roger Neilson House, Ottawa, ON, Canada.
Expert Opin Pharmacother. 2022 Jan;23(1):43-48. doi: 10.1080/14656566.2021.1965574. Epub 2021 Aug 18.
Perinatal palliative care (PnPC) is a growing field where healthcare providers from multiple disciplines are supporting families and providing holistic care for their babies with life-limiting illnesses. It is important to have an approach that includes the standardized management of end-of-life symptoms that are anticipated around the time of birth.
A need was identified to develop medication orders for the initial pharmacological management of symptoms at end-of-life for infants with life-limiting conditions intended for use outside of an intensive care setting. The choice of medications was based on a review of the literature, discussion with content experts and guided by their ease of use, accessibility and noninvasive route of delivery. The recommendations can be used as a guide for the initial management of common symptoms encountered in perinatal palliative care.
There are studies looking at many qualitative aspects of perinatal palliative care including perceptions of care, decision-making, and bereavement; however, few specifically focus on symptom management in the delivery room and postpartum ward settings. There is a need for standardization of the medical management of infants born with life-limiting conditions whose parents choose to pursue palliative care.
围产期姑息治疗(PnPC)是一个不断发展的领域,来自多个学科的医疗保健提供者正在为有生命限制疾病的家庭提供支持,并为他们的婴儿提供全面的护理。重要的是要有一种方法,包括对预计在出生时出现的临终症状进行标准化管理。
我们发现需要制定药物医嘱,以便在重症监护环境之外,对患有生命限制疾病的婴儿进行临终期症状的初始药物治疗。选择药物的依据是对文献的回顾、与内容专家的讨论,并根据其易用性、可及性和非侵入性给药途径进行指导。这些建议可作为围产期姑息治疗中常见症状的初始管理指南。
有一些研究关注围产期姑息治疗的许多定性方面,包括护理的看法、决策和丧亲;然而,很少有研究专门关注分娩室和产后病房环境中症状的管理。对于选择姑息治疗的患有生命限制疾病的婴儿,需要对其进行标准化的医疗管理。