Management of respiratory symptoms in paediatric palliative care

Abstract

In the absence of well designed paediatric studies we need to judiciously apply what we can extrapolate from adult studies to each child we are treating; selecting interventions and approaches carefully, adjusting them when there is no evidence of individual benefit.

Homöopathie in der Kinderpalliativmedizin

“…zu verlangsamen. [9,15]). Tatsächlich lässt sich Annas Atemnot dadurch bessern, allerdings werden ihre Bronchialsekrete immer zäher und lassen sich kaum noch abhusten oder absaugen.…”

“…So kann z. B. Morphin zur Schmerztherapie oder auch zur Linderung von Atemnot[9] und Lorazepam bei Angst und Aufregung gegeben werden und gleichzeitig eine Therapie mit der für den Patienten geeigneten homöopathischen Arznei erfolgen.In der Palliativmedizin, auch bei Kindern, sind einige Arzneien, die das Sterben begleiten und erleichtern, entsprechend der bewährten Indikation und der Repertorisation sehr gut bekannt: Besonders häufig kommen Arsenicum album (weißes Arsenik), Phosphorus (gelber oder weißer Phosphor) und Carbo vegetabilis (Holzkohle) neben vielen anderen Arzneien zum Einsatz[2][10][12]. Carbo vegetabilis benötigen Kinder mit eingesunkenem, blassem bis bläulichem Gesicht, häufig begleitet von blauen Lippen.…”

Palliative medicines for children – a new frontier in paediatric research

“…Although an evidence‐based approach is essential, limited research in PPC demands that much of the evidence is extrapolated from adult studies . These are often conducted in specific disease groups, with little relevance to the paediatric population . For example, reports on chronic pain are generally from case series, with few controlled trials in children and almost all chronic pain interventions have been adapted from their use in adult chronic pain.…”

“…There is a limited evidence base available for many of the therapeutic interventions in paediatric palliative care. For example, there is a paucity of data to guide clinicians in the use of pharmacotherapy for management of respiratory symptoms [8] and, although the number of analgesics available for managing pain has increased significantly over the last decade, the research evidence for the efficacy and safety of these drugs for children is limited. [9] Although an evidence-based approach is essential, limited research in PPC demands that much of the evidence is extrapolated from adult studies.…”

“…[10] These are often conducted in specific disease groups, with little relevance to the paediatric population. [8] For example, reports on chronic pain are generally from case series, with few controlled trials in children and almost all chronic pain interventions have been adapted from their use in adult chronic pain. This paucity of research in paediatric pain management was highlighted in a recent Cochrane review.…”