title: Preemptive use of palliative sedation and amyotrophic lateral sclerosis.
abstract: Patients in the advanced stages of amyotrophic lateral sclerosis often are faced with the dilemma of whether to use or continue to use mechanical ventilation. Patients who elect to terminate ventilatory support may be subject to significant and even extreme respiratory symptoms. Severe dyspnea and other symptoms are sometimes treated with palliative sedation, which is generally recommended as a last resort approach to refractory symptoms. However, the preemptive use of palliative sedation is sometimes appropriate. The preemptive use of palliative sedation is examined through a case-based analysis of a patient with advanced amyotrophic lateral sclerosis.
authors.affiliation: Hospice and Palliative Medicine, Division of Geriatric Medicine, and Clinical Ethics, Department of Medicine, Winthrop University Hospital, Mineola, NY, USA. jberger@winthrop.org
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Berger
mesh_terms: D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000628:therapy*; D004417:Dyspnea / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008140:Lorazepam / Q000627:therapeutic use*; D008297:Male; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D008140:Lorazepam