• Am J Hosp Palliat Care · May 2016

    Observational Study

    Palliative Sedation at the End of Life: Patterns of Use in an Israeli Hospice.

    • Daniel Azoulay, Ruth Shahal-Gassner, Malka Yehezkel, Ester Eliyahu, Nir Weigert, Eliana Ein-Mor, and Jeremy M Jacobs.
    • Hadassah Mount Scopus Hospice Unit for Palliative Care Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, and Hebrew University-Hadassah Medical School, Jerusalem, Israel adaniel@hadassah.org.il.
    • Am J Hosp Palliat Care. 2016 May 1; 33 (4): 369-73.

    AbstractPalliative sedation (PS) is indicated for refractory symptoms among dying patients. This retrospective descriptive study examines PS in an Israeli hospice. Palliative sedation was defined as PS to unconsciousness (PSU), PS proportionate to symptoms (proportional palliative sedation [PPS]), or intermittent PS (IPS). Among 179 patients who died during 2012, PS was used among 21.2% (n = 38): (PSU 34.2%, PPS 34.2%, and IPS 31.6%), using midazolam (n = 33/38), halidol (21/38), and concurrent morphine (n = 35/38). Indications included agitation (71%), pain (36.8%), and dyspnea (21%). Survival following initiation of PS was 73 ± standard deviation 54 hours. No differences in survival were observed according to who initiated the decision to use PS (patients/medical staff/family) or type of PS (PSU/PPS/IPS). Survival following PS was longest with higher sedative doses, an observation that may help dispel fears concerning the use of PS to hasten death. © The Author(s) 2015.

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