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Palliative sedation for children at end of life: a retrospective cohort study

Yang Chen1, Jianjun Jiang2, Wei Peng1

  • 1Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 18, Section 3, South Renmin Road, Wuhou District, Chengdu, Sichuan province, China.

BMC Palliative Care
|April 27, 2022
PubMed

Insights

Palliative sedation effectively manages complex symptoms in children at the end of life. This therapy improves symptom control without increasing hospitalization duration, offering crucial support during critical care.

Area of Science:

  • Pediatric Palliative Care
  • End-of-Life Symptom Management
  • Sedative Therapy

Background:

  • Palliative sedation involves intentionally reducing consciousness to relieve refractory symptoms.
  • Research on palliative sedation specifically for children is limited.
  • This study investigates symptom control and risks associated with sedative therapy in pediatric end-of-life care.

Purpose of the Study:

  • To evaluate the effectiveness of palliative sedation in managing symptoms in children nearing end of life.
  • To compare symptom relief, survival time, and hospitalization duration between sedated and non-sedated pediatric patients.
  • To identify potential risks and benefits of palliative sedation in a pediatric palliative care setting.

Main Methods:

  • A single-center, retrospective cohort study was conducted.
  • Pediatric patients who died in the Palliative Medicine Department were divided into two groups: palliative sedation (Group A) and non-palliative sedation (Group B).
  • Outcomes including symptom relief, survival time, and last hospitalization time were compared between the groups.

Main Results:

  • A total of 41 children died during the study period; 24 received palliative sedation (Group A) and 17 did not (Group B).
  • Group A experienced more complex symptoms (p=0.013) and demonstrated higher overall symptom relief (p=0.041) compared to Group B.
  • While pain relief rates and opioid doses did not differ significantly, Group A had a longer survival time after diagnosis (p=0.047), with similar hospitalization lengths.

Conclusions:

  • Palliative sedation is an effective method for controlling complex and painful symptoms in children at the end of life.
  • Sedative therapy in pediatric palliative care does not appear to shorten hospitalization time.
  • The findings support the use of palliative sedation for symptom management in pediatric end-of-life care.
Abstract

Keywords:
ChildrenEnd of lifePalliative carePalliative sedationSymptom control

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