Differences in physician-reported practice in palliative sedation therapy

Morita, Tatsuya

doi:10.1007/s00520-004-0603-8

Cited by 44 publications

(29 citation statements)

References 27 publications

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“…Practice of sedation in terminal ill patients has a wide divergence among palliative care specialists and no clear guidelines are available. 22,23 Although the terminal phases of this disease have turned out to be a symptom-and drug-intensive period, the management is up to the individual experience of personal engaged in the patients care. This requires further clinical research to develop evidencebased guidelines.…”

Section: Discussionmentioning

confidence: 99%

The End-of-Life Hospital Setting in Patients with Glioblastoma

Oberndorfer¹,

Lindeck‐Pozza²,

Lahrmann³

et al. 2008

Journal of Palliative Medicine

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Despite aggressive treatment, outcome of patients with glioblastoma is poor. Several distinct clinical problems arise in the terminal stage of this disease. The purpose of this study was to evaluate the end-of-life phase in a hospital setting in patients with glioblastoma. Twenty-nine consecutive patients with glioblastoma, who died in our department, were included in this analysis regarding symptoms, medication, diagnostics, and interventional procedures. The patients were comparable with respect to age, gender, and overall survival with data from the literature. Relevant clinical symptoms, medications, diagnostics, well as interventional procedures increased continuously toward end of life. Pain, epileptic seizures, and symptoms of brain edema were the most frequent clinical symptoms. According to this, most patients were on antiepileptic drugs (AED), steroids, and analgesics. In the last phase, symptoms from brain edema, fever, decrease of vigilance, dysphagia, and pneumonia were the prominent clinical features. Our study demonstrates that the end of life in patients with glioblastoma has several periods with different clinical aspects with respect to symptoms and treatment.

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Section: Discussionmentioning

confidence: 99%

The End-of-Life Hospital Setting in Patients with Glioblastoma

Oberndorfer¹,

Lindeck‐Pozza²,

Lahrmann³

et al. 2008

Journal of Palliative Medicine

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“…Ob im internationalen Vergleich unterschiedliche Kulturkreise mit ihren individuellen Wertesystemen und Behandlungsstandards im Bezug auf Symptomkontrolle zu jeweils verschiedenen Zeitpunkten einer (palliativen) Behandlung eine Indikation zur Sedierung erkennen oder das Vorgehen als solches subjektiv unterschiedlichen Definitionen unterliegt, erscheint möglich. Morita [9] berichtet über Einflussfaktoren auf die Verwendung palliativer Sedierung wie die ärztliche Auffassung von einem "guten Tod", der Glaube an Effekte von Sedierung auf das Überleben der Patienten sowie die medizinische Expertise und Erfahrung, die sich nicht für unsere Palliativstation bestätigen lassen.…”

Section: Diskussionunclassified

Indikationen und Gebrauch von Benzodiazepinen auf einer Palliativstation

Stiel

Krumm

Schroers³

et al. 2008

Schmerz

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“…Misunderstandings concerning probable life-shortening effects of PS and differentiating PS from euthanasia (2)(3)(4) may have led to barriers and concerns in the application of PS in clinical practice. Rather inconsistent treatment regimens and research findings on the definition (1,(5)(6)(7)(8), incidence (9,10), indications (10)(11)(12), medication, and general professionals' attitudes (13)(14)(15)(16)(17)(18) toward PS were reported (9,15). Due to these uncertainties, the necessity for standardized guidelines was expressed (19).…”

Section: Introductionmentioning

confidence: 95%