¿Cómo alimentar al paciente en cuidados paliativos? Una revisión narrativa

Diana Cárdenas

doi:10.35454/rncm.v4n2.243

Autores

Diana Cárdenas Universidad El Bosque https://orcid.org/0000-0002-0709-0307

DOI:

https://doi.org/10.35454/rncm.v4n2.243

Palavras-chave:

Nutrição, Nutrição parenteral, Cuidados paliativos

Resumo

A desnutrição é uma doença comum em pacientes com doenças incuráveis que se beneficiam de cuidados paliativos. O cuidado nutricional, parte integrante do tratamento desses pacientes, permite a administração adequada da terapia nutricional oral, enteral ou parenteral. Nesse contexto, a terapia nutricional é indicada com o objetivo de aumentar a sobrevida e a qualidade de vida de alguns pacientes, como aqueles com problemas neurológicos ou câncer. No entanto, há grande controvérsia sobre suas indicações e os benefícios potenciais em particular da nutrição parenteral domiciliar. Portanto, o objetivo desta revisão é responder a duas questões: Quando a terapia nutricional deve ser iniciada e quando deve ser interrompida? A terapia nutricional melhora a qualidade de vida e prolonga a sobrevida dos pacientes em cuidados paliativos? As sociedades científicas não recomendam a introdução da terapia nutricional em todos os casos de desnutrição, especialmente em pacientes hipofágicos se sua expectativa de vida for inferior a 2 meses. A nutrição parenteral pode beneficiar alguns pacientes que ja tem sido bem identificados, aumentando o tempo de sobrevida, porém o impacto na qualidade de vida permanece incerto.

As decisões devem ser tomadas de forma individualizada e respeitando a autonomia do paciente e evitando a obstinação terapêutica. Pesquisas em este campo devem avançar para determinar com maior certeza a relação risco-benefício da terapia nutricional.

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