ArticleBMC palliative care2018
Continuous palliative sedation for patients with advanced cancer at a tertiary care cancer center.
Article in BMC palliative care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Guideline for Medication Management of Distressing Symptoms in Older Patients Receiving End-of-Life Palliative Care.Journal of evidence-based medicine · 2026Guideline
- "Total nausea" as a manifestation of "total pain" and an expression of suffering: a case report.Journal of medical case reports · 2026Article
- Attitudes and practices of hospice physicians regarding palliative sedation: a cross-sectional descriptive study.BMJ open · 2025Article
- Refractory symptoms and end of life midazolam use in cancer patients, a single center experience.Palliative & supportive care · 2025Article
- Frequency and predictors of palliative sedation among patients with cancer who died in a specialist inpatient palliative care unit: a retrospective study.BMC palliative care · 2025Article
- Article
- Practices of and Perspectives on Palliative Sedation Among Palliative Care Physicians in Ontario, Canada: A Mixed-Methods Study.Palliative medicine reports · 2024Article
- Dexmedetomidine Combined With Patient-Controlled Analgesia for Palliative Sedation in Terminal-Stage Cancer Patients With Refractory Pain: A Retrospective Analysis of Nine Cases.Pain research & management · 2024Article
- Survival Outcomes in Palliative Sedation Based on Referring Versus On-Call Physician Prescription.Journal of clinical medicine · 2023Article
- Observational
- Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis.Cancers · 2023Review
- Management of Physical Symptoms in Patients with Advanced Cancer during the Last Weeks and Days of Life.Cancer research and treatment · 2022Review
- Impact of legalization of Medical Assistance in Dying on the Use of Palliative Sedation in a Tertiary Care Hospital: A Retrospective Chart Review.The American journal of hospice & palliative care · 2022Article
- Characteristics Associated with Survival in Patients Receiving Continuous Deep Sedation in a Hospice Care Unit.Journal of hospice and palliative care · 2021Article
- How to measure the effects and potential adverse events of palliative sedation? An integrative review.Palliative medicine · 2021Review
- Association between continuous deep sedation and survival time in terminally ill cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2021Article
- Palliative sedation and medical assistance in dying: Distinctly different or simply semantics?Nursing inquiry · 2020Article
- Medical staff opposition to a deep and continuous palliative sedation request under Claeys-Leonetti law.BMC palliative care · 2019Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPalliative sedation (PS) is an intervention to treat refractory symptoms and to relieve suffering at the end of life. Its prevalence and practice patterns vary widely worldwide. The aim of our study was to evaluate the frequency, clinical indications and outcomes of PS in advanced cancer patients admitted to our tertiary comprehensive cancer center.
methodsWe retrospectively studied the use of PS in advanced cancer patients who died between March 1st, 2012 and December 31st, 2014. PS was defined as the use of continuous infusion of midazolam or neuroleptics for refractory symptoms in the end of life. This study was approved by the Research Ethics Committee of our institution (project number 2481-15).
resultsDuring the study period, 552 cancer patients died at the institution and 374 met the inclusion criteria for this study. Main reason for exclusion was death in the Intensive Care Unit. Among all included patients, 54.2% (n = 203) received PS. Patients who received PS as compared to those not sedated were younger (67.8 vs. 76.4 years-old, p < 0.001) and more likely to have a diagnosis of lung cancer (23% vs. 14%, p = 0.028). The most common indications for sedation were dyspnea (55%) and delirium (19.7%) and the most common drugs used were midazolam (52.7%) or midazolam and a neuroleptic (39.4%). Median initial midazolam infusion rate was 0.75 mg/h (interquartile range - IQR - 0.6-1.5) and final rate was 1.5 mg/h (IQR 0.9-3.0). Patient survival (length of hospital stay from admission to death) of those who had PS was more than the double of those who did not (33.6 days vs 16 days, p < 0.001). The palliative care team was involved in the care of 12% (n = 25) of sedated patients.
conclusionsPS is a relatively common practice in the end-of-life of cancer patients at our hospital and it is not associated with shortening of hospital stay. Involvement of a dedicated palliative care team is strongly recommended if this procedure is being considered. Further research is needed to identify factors that may affect the frequency and outcomes associated with PS.
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