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Sedation in specialized palliative care: A cross-sectional study.
Hedman, Christel; Rosso, Aldana; Häggström, Ola; Nordén, Charlotte; Fürst, Carl Johan; Schelin, Maria E C.
Afiliación
  • Hedman C; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
  • Rosso A; Division of Palliative Care, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
  • Häggström O; The Institute for Palliative Care at Lund University and Region Skåne, Lund, Sweden.
  • Nordén C; R&D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden.
  • Fürst CJ; Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
  • Schelin MEC; Unit of Palliative Care Kristianstad, Region Skåne, Kristianstad, Sweden.
PLoS One ; 17(7): e0270483, 2022.
Article en En | MEDLINE | ID: mdl-35802571
BACKGROUND: Palliative sedation is used to relieve refractory symptoms and is part of clinical practice in Sweden. Yet we do not know how frequently this practice occurs, how decision-making takes place, or even which medications are preferentially used. OBJECTIVES: To understand the current practice of palliative sedation in Sweden. METHODS: We conducted a retrospective cross-sectional medical record-based study. For 690 consecutive deceased patients from 11 of 12 specialized palliative care units in the southernmost region of Sweden who underwent palliative sedation during 2016, we collected data on whether the patient died during sedation and, for sedated patients, the decision-making process, medication used, and depth of sedation. RESULTS: Eight percent of patients were sedated. Almost all (94%) were given midazolam, sometimes in combination with propofol. The proportions of sedation were similar in the patient groups with and without cancer. The largest proportion of the sedated patients died in inpatient care, but 23% died at home, with specialized palliative home care. Among the patients with a decision to sedate, 42% died deeply unconscious, while for those without such a decision the corresponding figure was 16%. In only one case was there more than one physician involved in the decision to use palliative sedation. CONCLUSION: 8% of patients in specialized palliative care received palliative sedation, which is lower than international measures but much increased compared to an earlier Swedish assessment. The level of consciousness achieved often did not correspond to the planned level; this, together with indications of a scattered decision process, shows a need for clear guidelines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidado Terminal / Sedación Profunda / Neoplasias Tipo de estudio: Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cuidado Terminal / Sedación Profunda / Neoplasias Tipo de estudio: Guideline / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos