Ética na decisão terapêutica em condições de prematuridade extrema

Éthics related to therapeutic decision in cases of extreme prematurity

Ética en las decisiones de tratamiento en condiciones de prematuridad extrema

Resumos

Os limites de viabilidade na prematuridade e a sobrevivência com mínimo de sequela são temas atuais de grande importância ética. A prematuridade extrema pode resultar em inúmeras sequelas e danos crônicos que limitam a funcionalidade. Ao se optar pelo prolongamento da vida de recém-nascidos muito imaturos, há maior exposição do prematuro e da família a situações de dor, desconforto e estresse. A presente revisão trata dos aspectos éticos relacionados a essa tomada de decisão considerando o limite de viabilidade e as sequelas neuropsicomotoras decorrentes da prematuridade extrema. Atualmente, a questão gira em torno da importância da valorização não só da sobrevivência desses prematuros, mas também da manutenção de sua qualidade de vida, uma vez que são mais predispostos a sequelas em curto, médio e longo prazos.

Prematuro; Ética; Recém-nascido de peso extremamente baixo ao nascer; Desenvolvimento infantil

Limits of viability for premature infants and survival with minimal consequences are current themes of great importance for ethics and bioethics. Extreme prematurity may result in many consequences and chronic injuries that limit the infant functionality. When prolongation of a very immature newborn's life is opted, there is a greater exposure of premature infants and their family to pain, distress and physiological stress situations. The present review approaches ethical aspects related to this decision-making, considering the limit of viability and neuromotor sequelae derived from extreme prematurity. At present, it is considered not only the survival of extreme premature infants, but also the maintenance of their quality of life, since they are more likely to have sequelae at short, median and long time.

Premature infant; Ethics; Extremely low birth weight infant; Child development

Los límites de la viabilidad de la prematuridad y la supervivencia con secuelas mínimas son las principales cuestiones éticas de actualidad . La prematuridad extrema puede dar lugar a numerosas secuelas y daños crónicos que limitan la funcionalidad. Cuando se opta por la prolongación de la vida de los recién nacidos muy inmaduros, aumenta la exposición del prematuro y de la familia a situaciones de dolor, malestar y estrés. Esta revisión discute los temas éticos relacionados con esta toma de decisión teniendo en cuenta el límite de la viabilidad y las secuelas neuropsicomotoras como consecuencia de la prematuridad extrema. En la actualidad, la cuestión gira en torno a la importancia de valorar no sólo la supervivencia de los bebés prematuros, sino también el mantenimiento de su calidad de vida, ya que son más propensos a las secuelas en el corto, mediano y largo plazo.

Prematuro; Ética; Recién nacido con peso al nacer extremadamente bajo; Desarollo infantil

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Datas de Publicação

• Publicação nesta coleção
  05 Jan 2015
• Data do Fascículo
  Dez 2014

Histórico

• Aceito
  28 Out 2014
• Recebido
  06 Fev 2014
• Revisado
  09 Maio 2014