Place des soins palliatifs en salle de naissance dans la prise en charge des prématurés de moins de 24 semaines d’aménorrhée. Expérience de 2 maternités

Pierre, M.; Plu, Isabelle; Hervé, Christian; Bétrémieux, P.

doi:10.1016/j.arcped.2011.01.031

Cited by 13 publications

(1 citation statement)

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“…An imperative for all caregivers seeking to make the unbearable more tolerable is to explain, describe, and inform so as to shed light on this demise and to inscribe it in the natural process of life. In this context, the perception by loved ones of the feelings of caregivers regarding gasps, of a perceptible awkwardness of personnel ill at ease or on the contrary more “supportive” and able to speak of what is happening as a troubling but natural phenomenon, would also contribute to a greater acceptance (or not) of these end-of-life signs [13]. Likewise, the words used to describe gasps—like the “agony of agonal respiration”—should be chosen carefully as they have highly negative connotations and are associated in our minds with something greatly painful suggestive of suffering.…”

Section: Reviewmentioning

confidence: 99%

Ethical reflections on end-of-life signs and symptoms in the intensive care setting: a place for neuromuscular blockers?

Daubin¹,

Haddad²,

Folscheid³

et al. 2014

Ann Intensive Care

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Background: High inspiratory oxygen concentrations are frequently administered in ventilated patients in the intensive care unit (ICU) but may induce lung injury and systemic toxicity. We compared beliefs and actual clinical practice regarding oxygen therapy in critically ill patients. Methods: In three large teaching hospitals in the Netherlands, ICU physicians and nurses were invited to complete a questionnaire about oxygen therapy. Furthermore, arterial blood gas (ABG) analysis data and ventilator settings were retrieved to assess actual oxygen practice in the same hospitals 1 year prior to the survey. Results: In total, 59% of the 215 respondents believed that oxygen-induced lung injury is a concern. The majority of physicians and nurses stated that minimal acceptable oxygen saturation and partial arterial oxygen pressure (PaO 2 ) ranges were 85% to 95% and 7 to 10 kPa (52.5 to 75 mmHg), respectively. Analysis of 107,888 ABG results with concurrent ventilator settings, derived from 5,565 patient admissions, showed a median (interquartile range (IQR)) PaO 2 of 11.7 kPa (9.9 to 14.3) [87.8 mmHg], median fractions of inspired oxygen (FiO 2 ) of 0.4 (0.4 to 0.5), and median positive end-expiratory pressure (PEEP) of 5 (5 to 8) cm H 2 O. Of all PaO 2 values, 73% were higher than the upper limit of the commonly self-reported acceptable range, and in 58% of these cases, neither FiO 2 nor PEEP levels were lowered until the next ABG sample was taken.

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Section: Reviewmentioning

confidence: 99%