Palliative Sedation at Home for Terminally Ill Children With Cancer

Title

Palliative Sedation at Home for Terminally Ill Children With Cancer

Creator

Korzeniewska-Eksterowicz A; Przysło Ł; Fendler W; Stolarska M; Młynarski W

Publisher

Journal Of Pain And Symptom Management

Date

2014

Subject

Palliative Care; Children; end of life; home care; Palliative sedation

Description

Context The presence of symptoms that are difficult to control always requires adjustment of treatment, and palliative sedation (PS) should be considered. Objectives We analyzed our experience in conducting PS at home for terminally ill children with cancer during a seven-year period. Methods We performed a retrospective analysis of medical records of children with cancer treated at home between the years 2005 and 2011. Results We analyzed the data of 42 cancer patients (18% of all patients); in 21 cases, PS was initiated (solid tumors n = 11, brain tumors [5], bone tumors [4], leukemia [1]). Sedation was introduced because of pain (n = 13), dyspnea (9), anxiety (5), or two of those symptoms (6). The main drug used for sedation was midazolam; all patients received morphine. There were no significant differences in the dose of morphine or midazolam depending on the patient's sex; age was correlated with an increase of midazolam dose (R = 0.68; P = 0.005). Duration of sedation (R = 0.61; P = 0.003) and its later initiation (R = 0.43; P = 0.05) were correlated with an increase of the morphine dose. All patients received adjuvant treatment; in patients who required a morphine dose increase, metoclopramide was used more often (P = 0.0002). Patients did not experience any adverse reactions. Later introduction of sedation was associated with a marginally higher number of intervention visits and a significantly higher number of planned visits (R = 0.53; P = 0.013). Conclusion Sedation may be safely used at home. It requires close monitoring and full cooperation between the family and hospice team. Because of the limited data on home PS in pediatric populations, further studies are needed.
2014-11

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

968-974

Issue

5

Volume

48

Citation

Korzeniewska-Eksterowicz A; Przysło Ł; Fendler W; Stolarska M; Młynarski W, “Palliative Sedation at Home for Terminally Ill Children With Cancer,” Pediatric Palliative Care Library, accessed October 19, 2021, https://pedpalascnetlibrary.omeka.net/items/show/14792.

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