Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2006-7-31
pubmed:abstractText
The noise produced by oscillatory movements of secretions in oropharynx, hypopharynx and trachea during inspiration and expiration in unconscious terminal patients is often described as 'the death rattle'. The reported incidence of death rattle in terminally ill patients varied between six and 92%. It is most commonly reported in patients dying from pulmonary malignancies, primary brain tumours or brain metastases, and predicts death within 48 hours in 75% of the patients. Clinical studies demonstrate that hyoscine hydrobromide is effective at improving symptoms. After withdrawal of artificial ventilation on the intensive care unit, excessive respiratory secretions resulting in rattling breathing, during the last hours of life, is not uncommon. Physicians and nurses experience considerable difficulties and frustrations in treating the death rattle. The distressing experience and negative influence in the bereavement process indicates an ethical demand to treat this symptom from the perspective of others merely than that of the patient. This article provides practical and ethical considerations in the management of this near-death symptom. The fact that relatives were relieved in almost all cases, in which a positive effect was obtained, makes treatment in anticipation of death rattle an ethical demand. In practice, injectable scopolamine is the reference drug for symptomatic treatment of death rattle.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
N
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Aug
pubmed:issn
0964-3397
pubmed:author
pubmed:issnType
Print
pubmed:volume
22
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
214-9
pubmed:meshHeading
pubmed-meshheading:16551501-Adult, pubmed-meshheading:16551501-Algorithms, pubmed-meshheading:16551501-Attitude of Health Personnel, pubmed-meshheading:16551501-Attitude to Death, pubmed-meshheading:16551501-Attitude to Health, pubmed-meshheading:16551501-Bereavement, pubmed-meshheading:16551501-Critical Care, pubmed-meshheading:16551501-Decision Trees, pubmed-meshheading:16551501-Family, pubmed-meshheading:16551501-Female, pubmed-meshheading:16551501-Frustration, pubmed-meshheading:16551501-Humans, pubmed-meshheading:16551501-Medical Futility, pubmed-meshheading:16551501-Prognosis, pubmed-meshheading:16551501-Respiration, Artificial, pubmed-meshheading:16551501-Respiratory Sounds, pubmed-meshheading:16551501-Scopolamine Derivatives, pubmed-meshheading:16551501-Sputum, pubmed-meshheading:16551501-Terminal Care, pubmed-meshheading:16551501-Time Factors, pubmed-meshheading:16551501-Withholding Treatment
pubmed:year
2006
pubmed:articleTitle
'Death rattle' after withdrawal of mechanical ventilation: practical and ethical considerations.
pubmed:affiliation
Department of Intensive Care and Department of Medical Ethics, Erasmus MC University Medical Center, Room V-208, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. e.j.o.kompanje@erasmusmc.nl
pubmed:publicationType
Journal Article, Review, Case Reports