Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2021
ReviewSugammadex to reverse neuromuscular blockade prior to withdrawal of life support.
In certain end-of-life scenarios, pharmacologic reversal of neuromuscular blockade may be indicated. However, given the depth of blockade frequently necessitated in the ICU setting, rapid reversal of neuromuscular blockade is generally not feasible with conventional reversal agents such as neostigmine that inhibit acetylcholinesterase. ⋯ We report the use of sugammadex to reverse neuromuscular blockade prior to compassionate extubation in three pediatric patients. Its clinical use in children is reviewed, potential applications in the palliative care arena discussed, and dosing algorithms presented.
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J Pain Symptom Manage · Aug 2021
Korean Version of the Patient Dignity Inventory: Translation and Validation in Patients with Advanced Cancer.
The goal of palliative care is to maximize the quality of life and thus maintain the dignity of patients facing problems associated with a life-threatening illness. The Patient Dignity Inventory (PDI) is an instrument used to measure various sources of distress that can impact patients' sense of dignity at the end of life. ⋯ Our findings indicate that the PDI-K is a valid and reliable instrument to measure dignity-related distress in patients with advanced cancer. This tool provides a four-factor Korean language alternative to the PDI.
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J Pain Symptom Manage · Aug 2021
Observational StudyAssessment of Palliative Care Needs in a Kenyan Intensive Care Unit Using a Trigger-Based Model.
Palliative care triggers have been used in the intensive care unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. ⋯ A trigger-based model, geared to the needs of the specific ICU, may be one way of improving integration of palliative care into the ICU, especially in sub-Saharan Africa.
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J Pain Symptom Manage · Aug 2021
ReviewA scoping review of end-of-life communication in international palliative care guidelines for acute care settings.
End-of-life communication in acute care settings can be challenging and many patients and families have reported low satisfaction with those conversations. ⋯ Palliative and end-of-life guidelines applicable to acute care settings outline the purpose of end-of-life communication and address how, when, and by whom such conversations are best initiated and facilitated. How guidelines are developed and what aspects of communications are included and emphasized may differ across countries related to role differences of physicians and nurses and national laws and regulations.
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J Pain Symptom Manage · Aug 2021
Randomized Controlled TrialPredictors of Response to an Evidence-based Behavioral Cancer Pain Management Intervention: An Exploratory Analysis from a Clinical Trial.
Interventions that teach patients cognitive and behavioral strategies for managing cancer pain have demonstrated effectiveness. Systematic reviews of such interventions call for research to inform their implementation in practice, including investigations into which patients are most likely to benefit. ⋯ Our findings elucidate several subgroups of patients who may be especially likely to benefit from PCST, informing both targeted implementation efforts and opportunities to improve delivery for diverse patients.