The use of drugs with a life-shortening effect in end-of-life care in neonates and infants
The purpose was to describe the use of drugs with a possible or certain life-shortening effect in end-of-life care in infants and to evaluate the possibly lethal effect. For 292/298 deaths of live born infants (
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| Veröffentlicht in: | Intensive care medicine 2006, Vol.32 (1), p.133-139 |
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| creator | PROVOOST, Veerle COOLS, Filip DELIENS, Luc BILSEN, Johan RAMET, José DECONINCK, Peter VANDER STICHELE, Robert VANDE VELDE, Anne VAN HERREWEGHE, Inge MORTIER, Freddy VANDENPLAS, Yvan |
| description | The purpose was to describe the use of drugs with a possible or certain life-shortening effect in end-of-life care in infants and to evaluate the possibly lethal effect.
For 292/298 deaths of live born infants ( |
| doi_str_mv | 10.1007/s00134-005-2863-2 |
| format | Article |
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For 292/298 deaths of live born infants (<1 year), in a 1-year period (between 1 August 1999 and 31 July 2000) in Flanders, Belgium, the attending physician could be identified and was sent an anonymous questionnaire. The questionnaires relating to deaths directly preceded by the administration of drugs were reviewed by a multi-disciplinary panel.
The response rate was 86.6% (253/292). In 57 cases (22.5%), drugs were administered directly before death. In 17/57 cases, the physician explicitly intended to hasten death. In 16/17 cases information about the drug(s) was available: opioids were administered in 14, a muscle relaxant in 5 and potassium chloride in 3 cases. In 13 cases where the lethal effect could be evaluated, the panel judged that the drugs were effective in hastening death in 10 cases. In most cases the estimated life-shortening was <24 h. In 40/57 cases the physician administered drugs to alleviate pain and/or symptoms, taking into account a possible life-shortening effect without explicitly intending it. Opioids were administered in all 30 cases where information about the drug(s) was supplied. In 13 cases the lethal effect could be evaluated, and in 6 cases the panel judged that the drugs had hastened death.
When life-shortening was explicitly intended, (dosages of) drugs were likely to be lethal. Drugs administered also clearly hastened death in some cases where life-shortening was not explicitly intended.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s00134-005-2863-2</identifier><identifier>PMID: 16292521</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Analgesics, Opioid ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Belgium ; Biological and medical sciences ; Clinical death. Palliative care. Organ gift and preservation ; Decision Making ; Dosage and administration ; Drug dosages ; Drug Utilization ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Ethical aspects ; Euthanasia ; Evaluation ; Health aspects ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infants ; Intensive care medicine ; Intention ; Medical sciences ; Medicine ; Muscle Relaxants, Central ; Narcotics ; Opioids ; Pain - drug therapy ; Palliative care ; Patient outcomes ; Pediatrics ; Physicians ; Potassium Chloride ; Practice ; Practice Patterns, Physicians ; Statistics ; Terminal care ; Terminal Care - ethics</subject><ispartof>Intensive care medicine, 2006, Vol.32 (1), p.133-139</ispartof><rights>2006 INIST-CNRS</rights><rights>COPYRIGHT 2006 Springer</rights><rights>Springer-Verlag 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c461t-508c61b626f38348f59031c305c68e8b3fa4314fa8cc3902d5637099ea6ddd133</citedby><cites>FETCH-LOGICAL-c461t-508c61b626f38348f59031c305c68e8b3fa4314fa8cc3902d5637099ea6ddd133</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4009,27902,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17408143$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16292521$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>PROVOOST, Veerle</creatorcontrib><creatorcontrib>COOLS, Filip</creatorcontrib><creatorcontrib>DELIENS, Luc</creatorcontrib><creatorcontrib>BILSEN, Johan</creatorcontrib><creatorcontrib>RAMET, José</creatorcontrib><creatorcontrib>DECONINCK, Peter</creatorcontrib><creatorcontrib>VANDER STICHELE, Robert</creatorcontrib><creatorcontrib>VANDE VELDE, Anne</creatorcontrib><creatorcontrib>VAN HERREWEGHE, Inge</creatorcontrib><creatorcontrib>MORTIER, Freddy</creatorcontrib><creatorcontrib>VANDENPLAS, Yvan</creatorcontrib><title>The use of drugs with a life-shortening effect in end-of-life care in neonates and infants</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>The purpose was to describe the use of drugs with a possible or certain life-shortening effect in end-of-life care in infants and to evaluate the possibly lethal effect.
For 292/298 deaths of live born infants (<1 year), in a 1-year period (between 1 August 1999 and 31 July 2000) in Flanders, Belgium, the attending physician could be identified and was sent an anonymous questionnaire. The questionnaires relating to deaths directly preceded by the administration of drugs were reviewed by a multi-disciplinary panel.
The response rate was 86.6% (253/292). In 57 cases (22.5%), drugs were administered directly before death. In 17/57 cases, the physician explicitly intended to hasten death. In 16/17 cases information about the drug(s) was available: opioids were administered in 14, a muscle relaxant in 5 and potassium chloride in 3 cases. In 13 cases where the lethal effect could be evaluated, the panel judged that the drugs were effective in hastening death in 10 cases. In most cases the estimated life-shortening was <24 h. In 40/57 cases the physician administered drugs to alleviate pain and/or symptoms, taking into account a possible life-shortening effect without explicitly intending it. Opioids were administered in all 30 cases where information about the drug(s) was supplied. In 13 cases the lethal effect could be evaluated, and in 6 cases the panel judged that the drugs had hastened death.
When life-shortening was explicitly intended, (dosages of) drugs were likely to be lethal. Drugs administered also clearly hastened death in some cases where life-shortening was not explicitly intended.</description><subject>Analgesics, Opioid</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Belgium</subject><subject>Biological and medical sciences</subject><subject>Clinical death. Palliative care. Organ gift and preservation</subject><subject>Decision Making</subject><subject>Dosage and administration</subject><subject>Drug dosages</subject><subject>Drug Utilization</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Ethical aspects</subject><subject>Euthanasia</subject><subject>Evaluation</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infants</subject><subject>Intensive care medicine</subject><subject>Intention</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Muscle Relaxants, Central</subject><subject>Narcotics</subject><subject>Opioids</subject><subject>Pain - drug therapy</subject><subject>Palliative care</subject><subject>Patient outcomes</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Potassium Chloride</subject><subject>Practice</subject><subject>Practice Patterns, Physicians</subject><subject>Statistics</subject><subject>Terminal care</subject><subject>Terminal Care - ethics</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNptklFrFDEQx4NY7PX0A_giwaJvqUkmm80-llKrUOhLffEl5LKTuy17SU12Eb-9We6gKMc8hBl-_2Fm_iHkveBXgvP2S-FcgGKcN0waDUy-IiuhQDIhwbwmKw5KMqWVPCcXpTxVutWNeEPOhZadbKRYkZ-PO6RzQZoC7fO8LfT3MO2oo-MQkJVdyhPGIW4phoB-okOkGHuWAlsA6l3GpRYxRTdhoS72NQ8uTuUtOQtuLPju-K7Jj6-3jzff2P3D3feb63vmlRYTa7jxWmy01AEMKBOajoPwwBuvDZoNBKdAqOCM99Bx2TcaWt516HTf9wJgTT4f-j7n9GvGMtn9UDyOo6tTzcXqVnOl2wX8-B_4lOYc62xW1otIgHrONbk8QFs3oq2rpCk7v3S016IB0QkwslLsBLXFiNmNKWIYavkf_uoEX6PH_eBPCsRB4HMqJWOwz3nYu_zHCm4X8-3BfFvNt4v5dtF8OO43b_bYvyiOblfg0xFwxbsxZBf9UF64VnFT_w_8BbJYslE</recordid><startdate>2006</startdate><enddate>2006</enddate><creator>PROVOOST, Veerle</creator><creator>COOLS, Filip</creator><creator>DELIENS, Luc</creator><creator>BILSEN, Johan</creator><creator>RAMET, José</creator><creator>DECONINCK, Peter</creator><creator>VANDER STICHELE, Robert</creator><creator>VANDE VELDE, Anne</creator><creator>VAN HERREWEGHE, Inge</creator><creator>MORTIER, Freddy</creator><creator>VANDENPLAS, Yvan</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2006</creationdate><title>The use of drugs with a life-shortening effect in end-of-life care in neonates and infants</title><author>PROVOOST, Veerle ; COOLS, Filip ; DELIENS, Luc ; BILSEN, Johan ; RAMET, José ; DECONINCK, Peter ; VANDER STICHELE, Robert ; VANDE VELDE, Anne ; VAN HERREWEGHE, Inge ; MORTIER, Freddy ; VANDENPLAS, Yvan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c461t-508c61b626f38348f59031c305c68e8b3fa4314fa8cc3902d5637099ea6ddd133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Analgesics, Opioid</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Belgium</topic><topic>Biological and medical sciences</topic><topic>Clinical death. Palliative care. Organ gift and preservation</topic><topic>Decision Making</topic><topic>Dosage and administration</topic><topic>Drug dosages</topic><topic>Drug Utilization</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. 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For 292/298 deaths of live born infants (<1 year), in a 1-year period (between 1 August 1999 and 31 July 2000) in Flanders, Belgium, the attending physician could be identified and was sent an anonymous questionnaire. The questionnaires relating to deaths directly preceded by the administration of drugs were reviewed by a multi-disciplinary panel.
The response rate was 86.6% (253/292). In 57 cases (22.5%), drugs were administered directly before death. In 17/57 cases, the physician explicitly intended to hasten death. In 16/17 cases information about the drug(s) was available: opioids were administered in 14, a muscle relaxant in 5 and potassium chloride in 3 cases. In 13 cases where the lethal effect could be evaluated, the panel judged that the drugs were effective in hastening death in 10 cases. In most cases the estimated life-shortening was <24 h. In 40/57 cases the physician administered drugs to alleviate pain and/or symptoms, taking into account a possible life-shortening effect without explicitly intending it. Opioids were administered in all 30 cases where information about the drug(s) was supplied. In 13 cases the lethal effect could be evaluated, and in 6 cases the panel judged that the drugs had hastened death.
When life-shortening was explicitly intended, (dosages of) drugs were likely to be lethal. Drugs administered also clearly hastened death in some cases where life-shortening was not explicitly intended.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>16292521</pmid><doi>10.1007/s00134-005-2863-2</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Intensive care medicine, 2006, Vol.32 (1), p.133-139 |
| issn | 0342-4642 1432-1238 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Analgesics, Opioid Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Belgium Biological and medical sciences Clinical death. Palliative care. Organ gift and preservation Decision Making Dosage and administration Drug dosages Drug Utilization Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Ethical aspects Euthanasia Evaluation Health aspects Hospitals Humans Infant Infant, Newborn Infants Intensive care medicine Intention Medical sciences Medicine Muscle Relaxants, Central Narcotics Opioids Pain - drug therapy Palliative care Patient outcomes Pediatrics Physicians Potassium Chloride Practice Practice Patterns, Physicians Statistics Terminal care Terminal Care - ethics |
| title | The use of drugs with a life-shortening effect in end-of-life care in neonates and infants |
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