Dexmedetomidine for dyspnoea

2020 ◽  
pp. bmjspcare-2020-002334
Author(s):  
Akiko Mano ◽  
Tomohiro Murata ◽  
Kazuma Date ◽  
Mitsuhiro Kawata ◽  
Miyuki Sato ◽  
...  
Keyword(s):  
Palliative Care ◽  
Intensive Care ◽  
Intravenous Infusion ◽  
Symptom Management ◽  
Care Setting ◽  
Terminally Ill ◽  
Pulmonary Haemorrhage ◽  
Continuous Intravenous Infusion ◽  
First Line ◽  
Palliative Care Setting

Dexmedetomidine is a selective α2-adrenoreceptor agonist with a broad range of effects, including easily controllable sedation, analgesia and anxiolysis. Because of these favorable features, it has replaced traditional sedatives, such as benzodiazepines, and is becoming the first-line sedative for the patients in intensive care units. Terminally ill patients often need sedatives for symptom management, especially for dyspnoea. However, the use of dexmedetomidine in a palliative care setting has rarely been recognised to date. We experienced a patient nearing the end of life due to uncontrollable pulmonary haemorrhage on ventilator, whose dyspnoea was successfully managed by dexmedetomidine in addition to continuous intravenous infusion of oxycodone.

Differences in Adverse Effect Profiles of Corticosteroids in Palliative Care Patients

2018 ◽  
Vol 36 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Leanna R. Jaward ◽  
Thomas A. O’Neil ◽  
Adam Marks ◽  
Michael A. Smith
Keyword(s):  
Adverse Effect ◽  
Palliative Care ◽  
Adverse Effects ◽  
Symptom Management ◽  
Care Setting ◽  
Management Strategies ◽  
Common Factors ◽  
Inclusion Criteria ◽  
Pubmed Database ◽  
Palliative Care Setting

Background: Corticosteroids are frequently utilized in the palliative care setting to combat symptoms such as fatigue, dyspnea, pain, weakness, anorexia, cachexia, nausea, and vomiting. Often times, adverse effects arise with corticosteroid use, and it is unclear whether switching to another corticosteroid would reduce the risk of specific adverse effects or what measures can be taken to alleviate the adverse effects. Objective: This article aims to review the differentiating pharmacokinetics, potency, and adverse effect profiles of corticosteroids and summarize their clinical applicability. Methods: A literature review of “corticosteroids” and “palliative care” was performed using the PubMed database through July 2018. Original studies relevant to the purpose of this study were identified and those that met inclusion criteria were included. Results: Although corticosteroids share many common factors, including similar pharmacokinetic, pharmacodymanic, and adverse effect profiles, they have significant differences when the details of these variables are reviewed. Providers that prescribe corticosteroids for symptom management should be aware of these differences and the recommended management strategies. Conclusions: Recognition of corticosteroid induced adverse effect profiles and possible management strategies is crucial to optimal symptom management in palliative care patients.

Music and Emotion in Palliative Care

1993 ◽  
Vol 9 (4) ◽  
pp. 48-52 ◽  
Author(s):  
Deborah Salmon
Keyword(s):  
Palliative Care ◽  
Music Therapy ◽  
Care Setting ◽  
Emotional Experience ◽  
Terminally Ill ◽  
Working Through ◽  
Palliative Care Setting ◽  
Music And Emotion

Music and emotion may share certain essential characteristics allowing the depth and breadth of music to resonate with that of emotional experience. It is perhaps this resonance which facilitates the experience, expression and working-through of feelings in music therapy work with the the terminally ill. The author explores five characteristics common to both music and emotion using clinical examples to illustrate how these might be at play in music therapy work in the palliative care setting.

Adapting Meaning-Centered Psychotherapy in the Palliative Care Setting

2017 ◽  
Author(s):  
Melissa Masterson ◽  
Barry Rosenfeld ◽  
Hayley Pessin ◽  
Natalie Fenn
Keyword(s):  
Palliative Care ◽  
Meaning In Life ◽  
Care Setting ◽  
Death And Dying ◽  
Terminally Ill ◽  
Health Needs ◽  
Mental Health Needs ◽  
Serious Illness ◽  
Palliative Care Setting ◽  
Case Vignettes

Meaning-centered psychotherapy (MCP) has demonstrated effectiveness in aiding patients with advanced cancer search for and attain a sense of meaning in life despite serious illness. Work with MCP and decades of research focused on the mental health needs of palliative care patients led to the development of an abbreviated version of MCP specifically tailored to palliative care patients. This chapter describes the development of a three-session adaptation of MCP called meaning-centered psychotherapy—palliative care (MCP-PC), along with an overview of the session content. Session transcripts and case vignettes are used to highlight results from the initial pilot study. These preliminary results provide support for the feasibility, acceptability, and effectiveness of this intervention in helping terminally ill patients in hospice or palliative care settings better cope with the challenges inherent in confronting death and dying.

Validation of the Phase II Feasibility Study in a Palliative Care Setting

2012 ◽  
Vol 30 (8) ◽  
pp. 752-758 ◽  
Author(s):  
Cindy Lee ◽  
Ryash Vather ◽  
Anne O’Callaghan ◽  
Jackie Robinson ◽  
Briar McLeod ◽  
...  
Keyword(s):  
Palliative Care ◽  
Feasibility Study ◽  
Phase Ii ◽  
Care Setting ◽  
Palliative Care Setting

Outcome measures for holistic, complex interventions within the palliative care setting

2008 ◽  
Vol 14 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Elizabeth Anita Thompson ◽  
Tina Quinn ◽  
Charlotte Paterson ◽  
Helen Cooke ◽  
Deidre McQuigan ◽  
...  
Keyword(s):  
Palliative Care ◽  
Outcome Measures ◽  
Care Setting ◽  
Complex Interventions ◽  
Palliative Care Setting

scholarly journals Bereaved spouses' adjustment after the patients' death in palliative care

2007 ◽  
Vol 5 (4) ◽  
pp. 397-404 ◽  
Author(s):  
Maria E. Carlsson ◽  
Ingrid M. Nilsson
Keyword(s):  
Palliative Care ◽  
Sleep Disturbance ◽  
Care Setting ◽  
Significant Decline ◽  
First Year ◽  
Inclusion Criteria ◽  
Life Situation ◽  
Palliative Care Setting ◽  
Advanced Home Care ◽  
Grief Reactions

ABSTRACTObjectives:To improve the support to bereaved spouses during the year after the patient's death, a project was started consisting of three visits by a nurse (after 1, 3, and 13 months) with conversations about the patient's death and the spouse's life situation. The aim of this study was to describe the bereaved spouse's situation and adaptation during the first year after the loss.Methods:Spouses of patients cared for by The Advanced Home Care Team (APHCT) in Uppsala, Sweden, were invited to participate in the project. Each participant was encouraged to talk freely about his or her situation, but enough direction was given to ensure that all items listed on a standardized questionnaire were covered.Results:Fifty-one spouses met the inclusion criteria and were invited to participate and 45 accepted. The subjects felt quite healthy but were tired and suffered from sleep disturbance. The grief reactions had initially been high but showed a significant decline from 1 to 13 months (p < .01). Forty-nine percent had experienced postbereavement hallucinations.Significance of results:This study showed that the bereaved spouses felt quite healthy and adjusted quite well to their new life situation, after the patient's death in a palliative care setting. The grief reactions had initially been high but showed a significant decline during the year.

Choice of access route for artificial nutrition in cancer patients: thirty years of activity in a home palliative care setting

Nutrition ◽  
2021 ◽  
pp. 111264
Author(s):  
Enrico Ruggeri ◽  
Marilena Giannantonio ◽  
Rita Ostan ◽  
Federica Agostini ◽  
Anna Simona Sasdelli ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Care Setting ◽  
Artificial Nutrition ◽  
Access Route ◽  
Palliative Care Setting

Uptake of clinical trials in a palliative care setting: A retrospective cohort study

2014 ◽  
Vol 11 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Peter Eastman ◽  
Brian Le ◽  
Gillian McCarthy ◽  
James Watt ◽  
Mark Rosenthal
Keyword(s):  
Palliative Care ◽  
Clinical Trials ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Setting ◽  
Palliative Care Setting
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