Órdenes de no reanimación en el paciente adulto
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resucitación cardiopulmonar
bioética
paro cardiaco
ética

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Órdenes de no reanimación en el paciente adulto. (2017). Universitas Medica, 57(3), 374-382. https://doi.org/10.11144/Javeriana.umed57-3.onrc
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Resumo

Con base en los malos resultados de la reanimación cardiopulmonar, hace más de tres décadas se adoptaron en la práctica clínica las órdenes de no reanimación. De manera más actual y dado el desarrollo de las garantías individuales y su adopción en la práctica clínica, se entiende por órdenes de no reanimación las decisiones concertadas entre los médicos y sus pacientes o representantes de no ser sometidos a una reanimación cardiocerebropulmonar en el evento de sufrir un paro cardiaco.
Poco a poco se ha ido aceptando la definición de límites en la actividad asistencial en consideración a sus resultados ulteriores en la vida de las personas; sin embargo, aún no es clara la compatibilidad de este tipo de decisiones —calificadas como restrictivas— en pacientes que necesitan algún tipo de tratamiento. El objetivo de este artículo es establecer el marco conceptual de este dilema y ofrecer una respuesta sobre la formulación, consecuencias e implicaciones de una orden de no reanimación.

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Mohr M, Kettler D. Ethical aspects of resuscitation.

Br J Anaesth. 1997;79:253-9.

McBrien M, Heyburn G. Do not attempt

resuscitation orders in the peri-operative

period. Anaesthesia. 2006;61:625-7.

Gempeler F. Reanimación cardiopulmonar

más allá de la técnica. Rev Col Anestesiol.

;43:142-6.

Angus DC. Successful resuscitation from

in-hospital cardiac arrest: What happens

next? JAMA. 2015;314:1238-9.

Fendler TJ, Spertus JA, Kennedy KF,

Chen LM, Perman SM, Chan PS. Alignment

of do-not-resuscitate status with

patients’ likelihood of favorable neurological

survival after in-hospital cardiac

arrest. JAMA. 2015;314:1264-71.

Link MS, Berkow LC, Kudenchuk PJ,

Halperin HR, Hess EP, Moitra VK, et

al. Part 7: Adult advanced cardiovascular life support: 2015 American Heart

Association guidelines update for cardiopulmonary

resuscitation and emergency

cardiovascular care. Circulation.

;132(suppl 2):S444-64.

British Medical Association, Resuscitation

Council (UK) and Royal College of

Nursing. Decisions relating to cardiopulmonary

resuscitation [internet]. London;

October 2014. Disponible en: http://bma.

org.uk/-/media/files/pdfs/práctical %20

advice %20at %20work/ethics/decisionsrelatingresusreport.

pdf

Gill R. Decisions relating to cardiopulmonary

resuscitation: commentary 1:

CPR and the cost of autonomy. J Med

Ethics. 2001;27:317-8.

Monzon JL, Saralegui R, Molina R,

Abizanda R, Cruz Martín M, Cabré L,

et al. Ética de las decisiones en resucitación

cardiopulmonar. Med Intensiva.

;34:534-49.

Guarisco KK. Managing do-not-resuscitate

orders in the peri anesthesia period. J

Perianesth Nurs. 2004;19:300-7.

Van Norman G. Do-not-resuscitate orders

during anaesthesia and urgent procedures

[internet]. 1998. Disponible en:

http://depts.washington.edu/bioethx/topics/

dnrau.html

Fritz Z, Fuld J. Ethical issues surrounding

do not attempt resuscitation orders: decisions,

discussion and deleterious effects.

J Med Ethics. 2010;36:593-7.

Association of Anaesthetists of Great

Britain and Ireland. Do Not Attempt

Resuscitation (DNAR) decisions in the

perioperative period [internet]. London;

Disponible en: http://www.aagbi.

org/sites/default/files/dnar_09_0.pdf

Rothenburg D. Informed refusal-DNR

orders in the patient undergoing anesthesia

and surgery at the end-of-life. In:

Van Norman G, editor. Clinical ethics in

anaesthesiology: A case based textbook.

Cambridge: Cambridge University Press;

p. 13-8.

Knipe M. Hardman JG. Past, present,

and future of ‘Do not attempt resuscitation’

orders in the perioperative period.

Br J Anaesth. 2013;111(6):861-3. doi:

1093/bja/aet287.

Burns JP, Edwards J, Johnson J, Cassem

NH, Truog RD. Do-not resuscitate

order after 25 years. Crit Care Med.

;31:1543-50.

Cereceda L. Orden de no reanimar, consideraciones

sobre este problema. Rev

Med Clin Condes. 2011;22:369-76.

Sentencia C-239/1997, homicidio por

piedad: elementos/homicidio pietístico o

eutanásico/homicidio eugenésico [internet].

Corte Constitucional colombiana.

Disponible en: http://www.corteconstitucional.

gov.co/relatoria/1997/c-239-97.

htm

Sentencia T-659/2012, derecho a la

educación [internet]. Corte Constitucional

colombiana. Disponible en:

http://www.corteconstitucional.gov.co/

relatoria/2002/T-659-02.htm

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