We need to talk about Trissomy 18

We need to talk about Trissomy 18

2^nd International Conference on Palliative Care
September 23-24, 2019 | Prague, Czech Republic

Maria Augusta B Cicaroni Gibelli

Ferriera RS, Brazil

Posters & Accepted Abstracts : J Prim Care Gen Pract

Abstract:

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.

Biography:

E-mail: maria.gibeli@hc.fm.usp.br

PDF HTML