Continuous Deep Sedation Until Death: First National Survey in France after the 2016 Law Promulgating It

Bretonnière, Sandrine; Fournier, Véronique

doi:10.1016/j.jpainsymman.2021.03.009

Cited by 5 publications

(6 citation statements)

References 24 publications

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“… 29–31 This may be appropriate and true, but empirical studies suggest that there are variations observed in actual clinical practice in treatment goals (symptom relief vs. deep sedation), the rapidity of dose titration (start sedatives as low as possible vs. high enough to achieve goal and then decrease), and planned duration of treatment (whether maintaining sedation until death is planned). 14 , 15 , 18 , 25 , 26 , 38 …”

Section: Discussionmentioning

confidence: 99%

“…Deep sedation initiated simultaneously with withdrawal of life-sustaining treatment legalized in France may be categorized into this type of sedative use. 25 , 26 Some insist that no chance of changing the treatment goal and no chance of discontinuing sedatives may be inappropriate as a palliative care measure.…”

Section: Four Types Of Sedative Usementioning

confidence: 99%

“… 23 , 24 More recently, a distinct form of CDS, deep sedation to be initiated simultaneously when life-sustaining treatment is withdrawn and maintained until death, was legalized in France. 25 , 26 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Defining “Continuous Deep Sedation” Using Treatment Protocol: A Proposal Article

Morita

Imai

Mori

et al. 2022

Palliative Medicine Reports

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Context: Continuous deep sedation (CDS) is regarded as a far-reaching form of sedative use for symptom control, but there are no established uniform definitions. Objectives: To propose types of sedative use related to CDS using treatment protocols with three parameters: documented treatment goals, rapidity of dose titration, and planned duration of treatment. Methods: Opinion article. Results: We propose four types of sedative use potentially related to CDS: (1) proportional sedation (treatment goal is symptom relief with regular monitoring to maximize patient communication, not a decrease in consciousness; with gradual use of sedatives; there is a chance to cease sedatives), (2) rapid proportional sedation (treatment goal is symptom relief with a rapid loading phase, followed by regular monitoring to maximize patient communication; there is a chance to cease sedatives), (3) deep sedation with a chance of cessation (deep sedation intended initially, followed by regular assessments of appropriateness of treatment goal; there is a chance to cease sedatives), and (4) continuous deep sedation until death (deep sedation indicated from initiation and maintained until death). Conclusion: This article proposes an idea that the use of treatment protocols that visualize treatment goals, rapidity of dose titration, and planned duration of treatment may help understand the existing variations in sedative use over the world. The use of treatment protocols in the same way when defining a medical treatment in other specialty fields might clear up the current confusion about the use of sedatives.

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Section: Discussionmentioning

confidence: 99%

Section: Four Types Of Sedative Usementioning

confidence: 99%

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Defining “Continuous Deep Sedation” Using Treatment Protocol: A Proposal Article

Morita

Imai

Mori

et al. 2022

Palliative Medicine Reports

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“…Dès 2016, la loi a prévu que cette sédation pouvait être réalisée au domicile du patient. Toutefois, les sénateurs reprennent les résultats d'une récente étude conduite par le Centre national des soins palliatifs et de la fin de vie 28 , laquelle identifie trois obstacles à sa réalisation en dehors de l'hôpital. Le premier tient à la restriction d'accès en ville au midazolam (que la Haute autorité de santé recommande pourtant en première intention à domicile 29 ), étant précisé qu'actuellement son usage est réservé à l'hôpital.…”

Section: B Mieux Appliquer La Sédation Profonde Et Continue Jusqu'au ...unclassified

Revisiter l’accompagnement des vieux en fin de vie, une ambition à portée de main ?

Bourdaire-Mignot¹,

Gründler²

2022

revdh

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“…Not maintaining this distinction has led, and still leads, to considerable confusion in the literature (Twycross 2019 , Kremling & Schildmann 2020 ). Here it is inexcusable given that the French Law is specifically about CDS (Bretonnaire & Fournier 2021 ).…”

mentioning

confidence: 99%

Response to “The opinion of French pulmonologists and palliative care physicians on non-invasive ventilation during palliative sedation at end of life: a nationwide survey’’

Twycross

Faull

Wenzel³

et al. 2023

BMC Palliat Care

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Continuous Deep Sedation Until Death: First National Survey in France after the 2016 Law Promulgating It

Cited by 5 publications

References 24 publications

Defining “Continuous Deep Sedation” Using Treatment Protocol: A Proposal Article

Defining “Continuous Deep Sedation” Using Treatment Protocol: A Proposal Article

Revisiter l’accompagnement des vieux en fin de vie, une ambition à portée de main ?

Response to “The opinion of French pulmonologists and palliative care physicians on non-invasive ventilation during palliative sedation at end of life: a nationwide survey’’

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