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Redefining the Relationship: Palliative Care in Critical Perinatal and Neonatal Cardiac Patients

Natasha S Afonso1, Margaret R Ninemire1, Sharada H Gowda2

  • 1Sections of Critical Care Medicine and Cardiology, Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX 77030, USA.

Children (Basel, Switzerland)
|July 2, 2021
PubMed

Insights

Congenital heart disease (CHD) in newborns requires ongoing family care and impacts parental mental health. Early pediatric palliative care (PC) can improve communication and coping for these families.

Area of Science:

  • Neonatal care
  • Pediatric cardiology
  • Palliative care

Background:

  • Congenital heart disease (CHD) presents unique challenges for neonates, leading to higher morbidity and mortality.
  • Families of infants with CHD face significant burdens, including chronic care needs and parental psychological distress (anxiety, depression).
  • The COVID-19 pandemic exacerbates stressors for families and healthcare providers involved in CHD care.

Purpose of the Study:

  • To review the evolving landscape of perinatal and neonatal congenital heart disease (CHD).
  • To emphasize the necessity of earlier and continuous integration of pediatric palliative care (PC).
  • To advocate for improved interdisciplinary care for patients with CHD and their families.

Main Methods:

  • This is a review article.
  • It synthesizes emerging literature on congenital heart disease (CHD) and palliative care (PC).
  • It highlights challenges and proposes solutions for integrating PC into CHD care.

Main Results:

  • Early pediatric palliative care (PC) consultation shows potential to enhance shared decision-making, communication, and coping mechanisms.
  • PC can help minimize non-beneficial medical interventions for infants with CHD.
  • Persistent barriers exist, primarily the misconception that PC signifies "giving up."

Conclusions:

  • Earlier and longitudinal integration of pediatric palliative care (PC) is crucial for optimizing care for neonates with CHD.
  • Addressing misconceptions about PC is vital for its effective implementation.
  • High-quality, interdisciplinary care is essential for improving outcomes for infants with CHD and their families.

Keywords:
congenital heart diseaseneonatologypalliative careperinatology

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