title: A survey of the sedation practice of Portuguese palliative care teams.
abstract: OBJECTIVE
  The purpose of this study is to study the practice of sedation by Portuguese palliative care teams.
  
  
  METHODS
  The teams included on the website of the Portuguese Association for Palliative Care were invited to participate. Data from all the patients sedated between April and June 2010 were recorded. Sedation was defined as the intentional administration of sedative drugs for symptom control, except insomnia, independently of the consciousness level reached.
  
  
  RESULTS
  Of the 19 teams invited only 4 actually participated. During the study period, 181 patients were treated: 171 (94 %) were cancer patients and 10 non-cancer patients. Twenty-seven (16 %) patients were sedated: 13 intermittently, 11 continuously, and 3 intermittently at first then continuously. The rate of sedation varied substantially among the teams. Delirium was the most frequent reason for sedation. Midazolam was the drug used in most cases. In 21 cases of sedation, the decision was made unilaterally by the professionals; in 16 (76 %) of those, the situation was deemed to be emergent. From the patients on continuous sedation, 9 (64 %) patients maintained oxygen, 13 (93 %) hydration, and 6 (43 %) nutrition. Two patients who had undergone intermittent sedation were discharged home and one was transferred to another institution; the reason for sedation in the three cases was delirium.
  
  
  CONCLUSIONS
  There is a substantial variation in the sedation rate among the teams. One of the most important aspects was the decision-making process which should be object of reflection and discussion in the teams.
authors.affiliation: Unidade de Cuidados Paliativos, Instituto Português de Oncologia, 4200-072 Porto, Portugal. ferrazg@netcabo.pt
authors.forename: Ferraz
authors.initials: F
authors.lastname: Gonçalves
authors.forename: Aida
authors.initials: A
authors.lastname: Cordero
authors.forename: Ana
authors.initials: A
authors.lastname: Almeida
authors.forename: Arlindo
authors.initials: A
authors.lastname: Cruz
authors.forename: Céu
authors.initials: C
authors.lastname: Rocha
authors.forename: Madalena
authors.initials: M
authors.lastname: Feio
authors.forename: Paula
authors.initials: P
authors.lastname: Silva
authors.forename: Salomé
authors.initials: S
authors.lastname: Barbas
authors.forename: Sandra
authors.initials: S
authors.lastname: Neves
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016292:Procedural Sedation / Q000706:statistics & numerical data*; D054810:Deep Sedation / Q000706:statistics & numerical data*; D003693:Delirium / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010166:Palliative Care / Q000706:statistics & numerical data*; D011174:Portugal; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam