title: Practice of palliative sedation in children with brain tumors and sarcomas at the end of life.
abstract: Despite progress in the treatment of pediatric cancer, approximately 25% of these children will die of the disease. The last period of life is characterized by profound physical and psychological suffering, both of the children and their loved ones. Adequate alleviation of this suffering becomes the priority in the management of these patients. The authors retrospectively evaluated the indications, incidence, and characteristics of palliative sedation (PS) in 19 children with brain tumors (BT) and 18 with sarcomas (S) at the end of life. Twelve of the 18 S patients received PS, as did 13 of the 19 BT patients. Indications for initiation of PS for those with BT were seizures and/or pain, for those with S were pain and/or respiratory insufficiency. It was concluded that PS may be the only efficacious and safe treatment for the alleviation of suffering in these children at the end of life, despite differing indications.
authors: Department of Pediatric Hematology-Oncology, Meyer Children's Hospital, Rambam Health Care Campus, Haifa, Israel. s postovsky@rambam.health.gov.il
authors: Sergey
authors: S
authors: Postovsky
authors: Bilal
authors: B
authors: Moaed
authors: Elena
authors: E
authors: Krivoy
authors: Ruth
authors: R
authors: Ofir
authors: Myriam Weyl
authors: MW
authors: Ben Arush
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy; D001932:Brain Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D003243:Consciousness / Q000187:drug effects; D005910:Glioma / Q000150:complications / Q000523:psychology / Q000628:therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000150:complications / Q000556:secondary / Q000628:therapy; D008874:Midazolam / Q000008:administration & dosage / Q000627:therapeutic use*; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D018242:Neuroectodermal Tumors, Primitive / Q000150:complications / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010166:Palliative Care / Q000379:methods; D010290:Parents / Q000523:psychology; D010361:Patients / Q000523:psychology; D012131:Respiratory Insufficiency / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012509:Sarcoma / Q000150:complications* / Q000523:psychology / Q000556:secondary / Q000628:therapy; D012640:Seizures / Q000188:drug therapy* / Q000209:etiology; D012983:Soft Tissue Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological; D013727:Terminal Care / Q000379:methods; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D009294:Narcotics; D009020:Morphine; D008874:Midazolam