JCO: Palliative Sedation: When and How? Commentary including references

 Blogger's Note: 
“Not everything that can be counted counts and not everything that counts can be counted.” Albert Einstein

                                           ~~~~~~~~~~~~~~
Commentary (on Maltoni et al):  Palliative Sedation: When and How?

REFERENCES

1. ↵
   1. Yennurajalingam S,
   2. Urbauer DL,
   3. Casper KL,
   4. et al.

   Impact of a palliative care consultation team on cancer-related symptoms in advanced cancer patients referred to an outpatient supportive care clinic. J Pain Symptom Manage, [epub ahead of print on August 24, 2010].
2. ↵
   1. Elsayem A,
   2. Curry E III,
   3. Boohene J,
   4. et al.

   (2009) Use of palliative sedation for intractable symptoms in the palliative care unit of a comprehensive cancer center. Support Care Cancer 17:53–59.
3. ↵
   1. Maltoni M,
   2. Scarpi E,
   3. Rosati M,
   4. et al.

   (2012) Palliative sedation in end-of-life care and survival: A systematic review. J Clin Oncol 30:1378–1383.
4. ↵
   1. Hui D,
   2. Elsayem A,
   3. De la Cruz M,
   4. et al.

   (2010) Availability and integration of palliative care at US cancer centers. JAMA 303:1054–1061.
5. ↵
   1. Bush SH,
   2. Bruera E

   (2009) The assessment and management of delirium in cancer patients. Oncologist 14:1039–1049.
6. ↵
   1. Delgado-Guay MO,
   2. Parsons HA,
   3. Li Z,
   4. et al.

   (2009) Symptom distress, interventions, and outcomes of intensive care unit cancer patients referred to a palliative care consult team. Cancer 115:437–445.

open access: JCO Editorial: Palliative Sedation: When and How?

 Palliative Sedation: When and How?

".....As with many other medical interventions, the controversy that
surrounds palliative sedation is not linked to the question of “yes or
no?” but rather, “when and how?”"

abstract and podcast: Palliative Sedation in End-of-Life Care and Survival: A Systematic Review [Palliative and Supportive Care] (unbearable suffering)

 Blogger's Note: search blog for other articles regarding palliative sedation

 
Palliative Sedation in End-of-Life Care and Survival: A Systematic Review [Palliative and Supportive Care]:

Purpose
Palliative sedation is a clinical procedure aimed at relieving refractory symptoms in patients with advanced cancer. It has been suggested that sedative drugs may shorten life, but few studies exist comparing the survival of sedated and nonsedated patients. We present a systematic review of literature on the clinical practice of palliative sedation to assess the effect, if any, on survival.

 Conclusion
Even if there is no direct evidence from randomized clinical trials, palliative sedation, when appropriately indicated and correctly used to relieve unbearable suffering, does not seem to have any detrimental effect on survival of patients with terminal cancer. In this setting, palliative sedation is a medical intervention that must be considered as part of a continuum of palliative care.
  
                            ~~~~~~~~~~~~~~~~~~~~~~~~

Users can play the podcast directly in the audio player embedded below. If Flash is disabled on your browser, you can save the file directly to your computer or open on your mobile device by clicking on "download file."

Sedation for the Management of Refractory Suffering
by Nathan Cherny


(Download file - duration 0:10:41, file size 9.80 MB)
This podcast presenter indicated no conflicts of interest.