Sedación paliativa para controlar el sufrimiento existencial refractario: diagrama de flujo
Resumen
Existe poco consenso en la literatura sobre cómo manejar el sufrimiento existencial refractario, un desafío clínico que puede ocurrir en el contexto del fin de la vida. Este artículo presenta el reporte de caso de un paciente ingresado en el Hospital de Apoyo de Brasília, quien requirió sedación paliativa para aliviar el sufrimiento existencial refractario y obtuvo un control satisfactorio de los síntomas. También
se elaboró un diagrama de flujo para la toma de decisiones, basado en una revisión que incluye las directrices europeas para la sedación paliativa, una herramienta útil para los clínicos en el contexto de cuidados paliativos.
Palabras clave:
Citas
Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, et al. Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol. 2017;35:96–112.
Braun LT, Grady KL, Kutner JS, Adler E, Berlinger N, Boss R, et al. Palliative Care and Cardiovascular Disease and Stroke: A Policy Statement From the American Heart Association/American Stroke Association. Circulation [Internet]. 2016 [citado 26 de abril de 2023];134. Disponível em: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000438
Saunders CM. Cicely Saunders: Selected Writings 1958—2004. 1o ed. Oxford: Oxford University Press;
Masso M, Allingham SF, Banfield M, Johnson CE, Pidgeon T, Yates P, et al. Palliative Care Phase: Inter-rater reliability and acceptability in a national study. Palliat Med. 2015;29:22–30.
Maltoni M, Miccinesi G, Morino P, Scarpi E, Bulli F, Martini F, et al. Prospective observational Italian study on palliative sedation in two hospice settings: differences in casemixes and clinical care. Support Care Cancer. 2012;20:2829–36.
Santos AFJ dos, Rodrigues LF. Manual de Terapia de Sedação Paliativa. 1o ed. Lemar & Goi; 2009. 243 p.
Voeuk A, Nekolaichuk C, Fainsinger R, Huot A. Continuous Palliative Sedation for Existential Distress? A Survey of Canadian Palliative Care Physicians’ Views. J Palliat Care. 2017;32:26–33.
Reich M, Bondenet X, Rambaud L, Ait-Kaci F, Sedda AL, Da Silva A, et al. Refractory psycho-existential distress and continuous deep sedation until death in palliative care: The French perspective. Palliat Support Care. 2020;18:486–94.
Rousseau P. Existential suffering and palliative sedation: a brief commentary with a proposal for clinical guidelines. Am J Hosp Palliat Care. 2001;18:151–3.
Morita T, Tsunoda J, Inoue S, Chihara S. Terminal sedation for existential distress. Am J Hosp Palliat Care. 2000;17:189–95.
Rousseau P. Existential distress and palliative sedation. Anesth Analg. 2005;101:611–2.
Arantzamendi M, Belar A, Payne S, Rijpstra M, Preston N, Menten J, et al. Clinical Aspects of Palliative Sedation in Prospective Studies. A Systematic Review. J Pain Symptom Manage. 2021;61:831-844.e10.
Ciancio AL, Mirza RM, Ciancio AA, Klinger CA. The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines. J Palliat Care. 2020;35:13–20.
Taylor BR, McCann PRM. Controlled Sedation for Physical and Existential Suffering? [Internet]. https://home.liebertpub.com/jpm. Mary Ann Liebert, Inc. 2 Madison Avenue Larchmont, NY 10538 USA; 2005 [citado 7 de maio de 2023]. Disponível em: https://www.liebertpub.com/doi/10.1089/jpm.2005.8.144
Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: the World Health Organization’s global perspective. J Pain Symptom Manage. 2002;24:91–6.
Cherny NI, Radbruch L, Board of the European Association for Palliative Care. European Association for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care. Palliat Med. 2009;23:581–93.
Cherny NI, ESMO Guidelines Working Group. ESMO Clinical Practice Guidelines for the management of refractory symptoms at the end of life and the use of palliative sedation. Ann Oncol Off J Eur Soc Med Oncol. 2014;25 Suppl 3:iii143-152.
Riley DS, Barber MS, Kienle GS, Aronson JK, Von Schoen-Angerer T, Tugwell P, et al. CARE guidelines for case reports: explanation and elaboration document. J Clin Epidemiol. 2017;89:218–35.
Zoccoli TLV, Ribeiro MG, Fonseca FN, Ferrer VC, organizadores. Desmistificando cuidados paliativos. 1o ed. Brasília: Oxigênio; 2019. 356 p.
Garetto F, Cancelli F, Rossi R, Maltoni M. Palliative Sedation for the Terminally Ill Patient. CNS Drugs. 2018;32:951–61.
Ricardo Tavares de Carvalho, Parsons HA, organizadores. Manual de Cuidados Paliativos ANCP. 2o ed. 2012.
Cherny NI, Portenoy RK. Sedation in the Management of Refractory Symptoms: Guidelines for Evaluation and Treatment. J Palliat Care. 1994;10:31–8.
Publicado:
Descargas
Cómo citar
Licencia
Derechos de autor 2024 Revista Bioética
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
