14 / 14
allied
academies
Page 73
September 23-24, 2019 | Prague, Czech Republic
2
nd
International Conference on
Palliative Care
Clinical Trials and Pharmacovigilance
Joint Event
&
We need to talk about Trissomy 18
Maria Augusta B Cicaroni Gibelli
Ferriera RS, Brazil
Trissomy 18 (T18) is the third most common chromosomal
disorder and a life-limiting condition. Recently, major surgical
interventions have been related to longer survival. When
should we consider curative and palliative care?
Aim:
To describe the treatment performed for patients with
Trissomy 18 in a Tertiary Neonatal Intensive Care Unit (NICU).
Methods:
Retrospective cohort of newborns with confirmed
diagnosis of Trissomy 18 by karyotype.
Results:
During a 19 months period, 2074 newborns were
admitted; 13 had Trissomy 18 (6.3:1000 live births). The
average time of hospitalization was 44 days. There were 9
(69.2%) deaths; 4 (30.8%) infants were discharged to their
homes. The average age of death was 35 days of life. All the
patients of the sample died before 1 year old. Non-invasive
ventilation was used in 6 (46.2%) for an average time of
15,2d. Invasive ventilation was used in 4 patients (30.8%) for
an average time of 12.5 d Cardiac surgery was performed
in 2(15.4%) patients;1 died after the surgery, the other was
discharged, but died with 7 months of age. In 2 (15.4%)
patients, the prostaglandin use was discontinued after
discussing the options with the families. Abdominal surgeries
were performed in 3(22.6%) patients with esophageal atresia
(2) or omphalocele (1). Gastrostomy was performed in
8(76%) patients. The goals of care were discussed with the
multidisciplinary team and the parents were encouraged to
participate in all decisions.
Conclusions:
In most patients, the treatment included
mechanical ventilation and surgical procedures. A palliative
care protocol to approach Trissomy 18 is necessary. All
possible disclosures and treatments should be discussed with
the parents considering the high morbidity and mortality of
each intervention made.
e
:
maria.gibeli@hc.fm.usp.brJournal of Primary Care and General Practice | Volume 2
J Prim Care Gen Pract, Volume:2