[Artificial nutrition in advanced palliative situations : Issues and recommendations]

This article focuses on the recommendations and issues of artificial nutrition (AN) in advanced palliative situations. In oncological situations, stages of cachexia and performance indexes help guide the decision-making process regarding the indications for AN. AN is usually not recommended in low performance indexes (Karnofsky ≤50 %, ECOG ≥ 3) nor in refractory cachexia. In some cases, a time-limited therapeutic trial may be suggested, with its effectiveness assessed by measurable goals. In advanced dementia, AN is not recommended. Often at the source of an AN request, the emotional aspect deserves to be explored in order to assess the patient's and his/her family's expectations and fears.