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Palliative Sedation Therapy in Pediatrics: An Algorithm and Clinical Practice Update

Andrea Cuviello1, Liza-Marie Johnson1, Kyle J Morgan2

  • 1St. Jude Children's Research Hospital, Memphis, TN 38105, USA.

Children (Basel, Switzerland)
|December 23, 2022
PubMed

Insights

Palliative sedation therapy (PST) helps pediatric patients with severe end-of-life suffering. This study provides an algorithm and guideline to improve PST use and symptom management.

Area of Science:

  • Pediatric Palliative Care
  • Clinical Practice Guidelines
  • End-of-Life Care

Background:

  • Palliative sedation therapy (PST) is crucial for pediatric patients experiencing refractory symptoms during the end-of-life (EOL) period.
  • Underutilization of PST may stem from variations in implementation, limited data in non-ICU settings, and educational gaps.
  • Standardized approaches are needed to optimize PST delivery.

Purpose of the Study:

  • To develop a clinical algorithm for identifying appropriate pediatric patients for PST.
  • To present a guideline for PST implementation adaptable to different clinical settings.
  • To facilitate the integration of PST into EOL care through case-based scenarios.

Main Methods:

  • Development of a clinical algorithm for PST patient selection.
  • Creation of a flexible guideline for PST implementation.
  • Inclusion of case-based scenarios to illustrate practical application.

Main Results:

  • The proposed algorithm ensures all symptom management modalities are considered before PST.
  • The guideline offers a framework for individualized PST implementation based on institutional resources.
  • Case studies demonstrate the practical application of the algorithm and guideline in EOL settings.

Conclusions:

  • A structured approach can improve the appropriate utilization of PST in pediatric EOL care.
  • The provided algorithm and guideline support consistent and individualized PST practices.
  • Enhanced education and standardized protocols are essential for optimizing PST for suffering pediatric patients.

Keywords:
dexmedetomidineend of lifepain managementpalliative carepalliative sedation therapypropofolsymptom management

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