Strategies used in the practice of palliative care in neopediatric intensive therapy




Palliative care; palliative care; neonatology; Neonatology; pediatrics; Pediatrics; intensive care unit; Intensive Care Unit.


When one thinks about the natural course of life, one imagines that the human being is born, grows, grows old and only then goes through the process of death. In a neonatal and pediatric intensive care unit - Neopediatric ICU, the course of life can be shortened, and the end of life can become a real fact for the newborn/child. When analyzing the actions taken towards the patient, in the case of nursing, the palliative approach follows a macro line of care, restricted to compliance with medical prescriptions and carrying out procedures. Given the importance of the palliative care approach, we raise the following question: What are the strategies used by physicians and nurses in the eligibility and palliative care of patients hospitalized in a neopediatric ICU, and their families? The articles were selected and organized following the PICO strategy. After delimiting the available literature, a careful analysis was carried out so that the most relevant topics in the articles could be organized. Several obstacles directly affect care, such as training, complexity of procedures, lack of privacy with patients and family members, professional unpreparedness, among others. Finally, it is concluded that the literature review managed to gather a consistent and very useful content, contributing to the enrichment of knowledge about Palliative Care and how medical and nursing professionals are able to approach palliative care in the neonatal ICU, always seeking to offer the best assistance to their patients and families despite all the challenges encountered in the routine of the service.


Almeida, F. A., Moraes, M. S., & Cunha, M. L. R. (2016). Taking care of the newborn dying and their families: Nurses' experiences of neonatal intensive care. Revista da Escola de Enfermagem da Usp, 122-129. DOI:

Baldissarella, L., & Dell’Aglio, D. D. (2009). No limite entre a vida e a morte um estudo de caso sobre a relação pais/bebê em uma UTI Neonatal. Estilos Clínicos, 14(26), 68-89. DOI: v14i26p68-89.

Bowlby, J. (2015). Formação e rompimento dos laços afetivos.

Callahan, K., Steinwurtzel, R., Brumarie, L., Schechter, S. & Parravicini, E. (2019). Early palliative care reduces stress in parents of neonates with congenital heart disease: validation of the “Baby, Attachment, Comfort Interventions”. Journal Perinatol, 1640–1647. DOI:

Côté, A. J., Payot, A., & Gaucher, N. (2020). Paediatric palliative care in practice: Perspectives between acute and long-term healthcare teams. Acta Paediatrica, 109(3), 613-619.

Grupo Ânima Educação. (2014). Manual Revisão Bibliográfica Sistemática Integrativa: a Pesquisa em Evidências.

Hhnner, N., & Boss, R. D. (2017). Neonatologist training in communication and palliative care. Seminars In Perinatology, 41(2), 106-110. DOI:

Kilcullen M., & Ireland, S. (2017). Palliative care in the neonatal unit: neonatal nursing staff perceptions of facilitators and barriers in a regional tertiary nursery. BMC Palliaivet Care, 16(1). DOI: 10.1186/s12904-017-0202-3.

Lledó-Morera, À., & Bosch-Alcaraz, A. (2020). Analysis of how nurses cope facing the death of a paediatric patient. Enfermagem Intensiva. DOI: 10.1016/j.enfi.2020.03.004. Epub ahead of print. PMID: 32855043.

Locatelli, C., Corvaglia, L., Simonazzi, G., Bisulli, M., Paolini, L., & Faldella, G. (2020). "Percorso giacomo": an italian innovative service of perinatal palliative care. Front Pediatr. DOI: 10.3389/fped.2020.589559.

Marcola, L., Barbosa, S. M. M., Zoboli, I., Polastrini, R. T. V. & Ceccon, M. E. J. (2017). Análise dos óbitos e cuidados paliativos em uma unidade de terapia intensiva neonatal. Revista. Paulista de pediatria, 35(2), 125-129. DOI:;2017;35;2;00012.

Marlow, N., Shaw, C., Connabeer, K., Aladangady, N., Gallagher, K., & Drew, P. (2021). End-of-life decisions in neonatal care: a conversation analytical study. Arch Dis Child Fetal Neonatal, 106(2), 184-188. DOI: 10.1136/archdischild-2020-319544.

Ng, S. K. F., Keenan, N., Swart, S. & Berry, M. J. (2018). Palliative care in a tertiary neonatal intensive care unit: a 10-year review. BMJ Supportive & Palliative Care. DOI: 10.1136/bmjspcare-2018-001538

Poles, K., & Bousso, R. S. (2004). Enfermeira e a família no processo de morte da criança: evidências do conhecimento. Revista Sociedade Brasileira de Enfermagem Pediátrica, 4(1), 11-18.

Schwartz, T. M., & Chalupka, S. (2019). Pediatric Palliative Care: Where Are We Now? Pediatric Nursing: Jannetti Publications, 45(5), 224-230.

Silva, I. N., Salim, N. R., Szylit, R., Sampaio, P. S. S., Ichikawa, C. R. F., & Santos, M. R. (2017). Knowing nursing team care practices in relation to newborns in end-of-life situations. Escola Anna Nery. GN1 Genesis Network, 21( 4), 1-7. DOI:

Silva, L. C. S. P., Valença, C. N., & Germano, R. M. (2010). Estudo fenomenológico sobre a vivência da morte em uma unidade de terapia intensiva neonatal. Revista Brasileira de Enfermagem, 63(5), 770-774.

Sociedade Brasileira de Pediatria (Brasil). (2017). Cuidados Paliativos Pediátricos: O que são e qual sua importância? Cuidando da criança em todos os momentos. Departamento Científico de Medicina da Dor e Cuidados Paliativos.

Verri, E. R., Bitencourt, N. A. S., Oliveira, J. A. S., Santos Junior, R., Marques, H. S., Porto, M. A., & Rodrigues, D. G. (2019). Profissionais de enfermagem: compreensão sobre cuidados paliativos pediátricos. Revista de Enfermagem Ufpe On Line, 13( 1), 126-136.

Vicensi, M. C. (2016). Reflexão sobre a morte e o morrer na UTI: a perspectiva do profissional. Revista Bioética, 24(1), 64-72.

World Health Organization. (2017). Palliative care.

World Health Organization. (2018). Integrating palliative care and symptom relief into paediatrics: a WHO guide for health care planners, implementers and managers.

Zimmermann, K., Cignacco, E., Engberg, S., Ramelet, A., Weid, N. V. D., Eskola, K., Bergstraesser, E., et al. (2018). Patterns of paediatric end-of-life care: a chart review across different care settings in Switzerland. Bmc Pediatrics, Springer Nature. DOI:



How to Cite

SILVA, A. E. .; SILVA, R. de P. .; SILVA, D. M. .; MORAES, H. C. F. .; MIRANDA, C. E. .; INÁCIO, J. L. da S. .; RIBEIRO, S. A. .; CARVALHO, T. V. . Strategies used in the practice of palliative care in neopediatric intensive therapy. Research, Society and Development, [S. l.], v. 10, n. 10, p. e506101018277, 2021. DOI: 10.33448/rsd-v10i10.18277. Disponível em: Acesso em: 8 dec. 2021.



Health Sciences