AI Article Synopsis
- - The study focuses on continuous and deep sedation maintained until death (CDSUD) in palliative care, especially for patients experiencing refractory suffering or who request to stop life-sustaining treatment.
- - A retrospective analysis of 42 hospitalized patients showed that 79% initiated CDSUD due to persistent suffering, with midazolam as the primary sedative, often combined with chlorpromazine and propofol.
- - Findings reveal an average sedation duration of 37 hours, with specific dosages for each sedative, contributing valuable insights into CDSUD practices in palliative care settings.
Article Abstract
Objectives: Limited descriptive data are available on continuous and deep sedation maintained until death (CDSUD) at the patient's request in palliative care units. This study aimed to describe such practices in the context of refractory suffering or after a request to stop life-sustaining treatment, evaluating the duration and dosage of sedative treatments used.
Methods: This retrospective observational study included consecutively hospitalised patients in a palliative care unit from January 2020 to December 2021. Data on patient profiles, reasons for the sedation request, duration of sedation and doses of sedatives were collected.
Results: Among 42 patients who underwent CDSUD, 79% occurred due to refractory suffering. In cases of sedation following a request to stop life support, high-dose corticosteroid therapy was the most commonly involved life-sustaining treatment. Midazolam was always the first-line sedative treatment. Chlorpromazine was added in 79% of cases, and propofol in 40%, to achieve a deep level of sedation. The mean maximum doses of midazolam, chlorpromazine and propofol were 7.6 mg/hour (±1.9), 3.3 mg/hour (±0.9) and 1.7 mg/kg/hour, respectively. The average duration of sedation was 37 hours.
Conclusions: This study provides new descriptive elements on CDSUD. Notably, it highlights the use of second-line sedative molecules, such as propofol.
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| http://dx.doi.org/10.1136/spcare-2023-004551 | DOI Listing |
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