DESENVOLVIMENTO DE DIRETRIZES INTERDISCIPLINARES PARA GASTROSTOMIA ENDOSCÓPICA PERCUTÂNEA EM PACIENTES COM ESCLEROSE LATERAL AMIOTRÓFICA

Abstract

This study aims to create a review in order to help build a multidisciplinary protocol for Percutaneous Endoscopic Gastrostomy (PEG) in patients with Amyotrophic Lateral Sclerosis (ALS), in order to standardize health routines with the best level of evidence for the conduct, management and health education guidelines for staff, patients, family members and caregivers at the Lauro Wanderley University Hospital. This is a literature review based on a search of databases emphasizing clinical, surgical, nutritional and ventilatory aspects for ALS patients undergoing GEP, as well as the various aspects that make up the care related to this procedure in this patient profile. Associated with this research were interviews with the teams at the Neurology and Gastroenterology Outpatient Clinics, the Center for Outpatient Surgery and Endoscopy (CECAE) and the Skin Commission of the aforementioned service, considering the main doubts and issues related to GEP and ALS in order to integrate the health care of the multi-professional team for these patients. As a result, a guide to nutritional recommendations was produced, taking into account the specificities of neuromuscular diseases, two decision-making algorithms for the nutritional and ventilatory management of these patients, as well as flowcharts for preoperative, perioperative and postoperative care and guidance, encompassing different aspects of the work of the multi-professional team, with their conduct directed towards the operative technique used to carry out the procedure. Finally, a guide to home care was also created, covering interdisciplinary care for the main doubts about home care. It is hoped that, as a result of this work, the clinical, surgical and multidisciplinary care of patients affected by ALS can be conducted in a standardized way with the best level of health evidence in order to ensure increased survival and quality of life for these patients, essential aspects in the management of incurable chronic neurological diseases.