Palliative Sedation in Patients Hospitalized in Internal Medicine Departments

Spanish and Portuguese Societies of Internal Medicine consensus guideline about best practice in end-of-life care

“…No entanto, um estudo recente multicêntrico sobre a sedação paliativa em últimos dias de vida mostrou que só um em cada três desses doentes é competente para tomar decisões. 67 Por isso, o médico deve-se assegurar de que as diretivas prévias do doente são seguidas, consultando instruções anteriores, expressas no testamento vital / diretivas antecipadas de vontade ou consultando diretamente aos seus familiares. …”

“…O estudo UDVIMI mostrou que só em 16,9% dos doentes se monitorizou o nível de sedação paliativa, numa escala. 67 A National Hospice and Palliative Care Organization recomenda que a sedação seja cuidadosamente controlada e titulada com proporcionalidade para obter alívio dos sintomas, e que para isso se utilizem escalas de sedação. 66 Recomendamos a escala Ramsay, pela sua simplicidade, mas escalas como a de Richmond 69,70 também podem ser úteis.…”

Palliative sedation for children at end of life: a retrospective cohort study

“…Various symptoms appear at the end of a child’s life, which are intractable, unmanageable and unrelievable and cause great suffering and distress to children, their families and caregivers [ 14 , 15 ]. Palliative sedation, which aims to relieve end of life refractory symptoms by reducing patient consciousness, was reported to be used for 12–64% of adults in palliative care [ 16 – 18 ] and for 48.4% of adults who die in hospitals at end of life with refractory symptoms [ 19 ]. Two studies in mainland China revealed that 22.3–33.6% of adult patients who died in the Palliative Department or Integrated Therapy Department received some form of palliative sedation [ 20 , 21 ].…”

Palliative Sedation for Children at End of Life: a Retrospective Cohort Study

“…Various symptoms appear at children's end-of-life, which are intractable, unmanageable and un-relievable, and cause great suffering and distress to children, their families and caregivers [14,15]. Palliative sedation, which aims to relieve end-of-life refractory symptoms by reducing patient's consciousness, is used in 12-64% of adults in palliative care [16][17][18] and in 48.4% of adults who die in hospital [19]. Although there has been demonstrated bene t of better symptom control in patients with a terminal illness, palliative sedation continues to gather some controversy [20,21].…”