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Palliative Sedation: Need for Consensus Guidelines and Standards

Palliative Sedation: Need for Consensus Guidelines and Standards INVITED COMMENTARY Palliative Sedation Need for Consensus Guidelines and Standards he first publications on the intentional lower- not included in the study). No differentiation in the depth ing of consciousness in patients with distress- of sedation was made. Also, it is not clear from this defi- T ing and refractory symptoms at the end of life nition whether the sedation was intentionally started or appeared in the 1990s. In 2001, Morita et al proposed rather a side effect of symptom-directed treatment, which to define palliative sedation as the use of sedative medi- makes the results difficult to compare with studies explic- cations (not narcotics) specifically to relieve intolerable itly concentrating on palliative sedation. and refractory distress by a reduction of patient con- Nevertheless, comparison of the results from 2001 with sciousness. This document highlights 2 important prin- those from 2007 shows a significant increase in the use ciples: (1) the intentional lowering of consciousness by of palliative sedation until death, from 8.2% to 14.5%. the use of sedatives, and (2) the distinction between light/ This increase occurred in all care settings, among both deep and intermittent/continuous sedation. However, sexes, all age groups, and in patients with various causes there http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Palliative Sedation: Need for Consensus Guidelines and Standards

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Publisher
American Medical Association
Copyright
Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2010.12
pmid
20212191
Publisher site
See Article on Publisher Site

Abstract

INVITED COMMENTARY Palliative Sedation Need for Consensus Guidelines and Standards he first publications on the intentional lower- not included in the study). No differentiation in the depth ing of consciousness in patients with distress- of sedation was made. Also, it is not clear from this defi- T ing and refractory symptoms at the end of life nition whether the sedation was intentionally started or appeared in the 1990s. In 2001, Morita et al proposed rather a side effect of symptom-directed treatment, which to define palliative sedation as the use of sedative medi- makes the results difficult to compare with studies explic- cations (not narcotics) specifically to relieve intolerable itly concentrating on palliative sedation. and refractory distress by a reduction of patient con- Nevertheless, comparison of the results from 2001 with sciousness. This document highlights 2 important prin- those from 2007 shows a significant increase in the use ciples: (1) the intentional lowering of consciousness by of palliative sedation until death, from 8.2% to 14.5%. the use of sedatives, and (2) the distinction between light/ This increase occurred in all care settings, among both deep and intermittent/continuous sedation. However, sexes, all age groups, and in patients with various causes there

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Mar 8, 2010

References