{"title":"右美托咪定（Dexmedetomidine）用于撤出支持期间的镇静。","authors":"Chris O'Hara, Robert F Tamburro, Gary D Ceneviva","doi":"10.4137/PCRT.S27954","DOIUrl":null,"url":null,"abstract":"<p><p>Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support. Despite opioids and benzodiazepines, she appeared to be uncomfortable after support was withdrawn. Ketamine was initiated. Relief from ketamine was brief, and its use was associated with a \"wide-eyed\" look that was distressing to the family. Ketamine was discontinued and a dexmedetomidine infusion was initiated. The patient's level of comfort improved greatly. The child died peacefully 24 hours after initiating dexmedetomidine from her underlying disease rather than the effects of the sedative. </p>","PeriodicalId":56348,"journal":{"name":"Palliative Care","volume":"9 ","pages":"15-8"},"PeriodicalIF":0.0000,"publicationDate":"2015-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551302/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dexmedetomidine for Sedation during Withdrawal of Support.\",\"authors\":\"Chris O'Hara, Robert F Tamburro, Gary D Ceneviva\",\"doi\":\"10.4137/PCRT.S27954\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support. Despite opioids and benzodiazepines, she appeared to be uncomfortable after support was withdrawn. Ketamine was initiated. Relief from ketamine was brief, and its use was associated with a \\\"wide-eyed\\\" look that was distressing to the family. Ketamine was discontinued and a dexmedetomidine infusion was initiated. The patient's level of comfort improved greatly. The child died peacefully 24 hours after initiating dexmedetomidine from her underlying disease rather than the effects of the sedative. </p>\",\"PeriodicalId\":56348,\"journal\":{\"name\":\"Palliative Care\",\"volume\":\"9 \",\"pages\":\"15-8\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2015-08-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551302/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Palliative Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4137/PCRT.S27954\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2015/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Palliative Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4137/PCRT.S27954","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2015/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Dexmedetomidine for Sedation during Withdrawal of Support.
Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support. Despite opioids and benzodiazepines, she appeared to be uncomfortable after support was withdrawn. Ketamine was initiated. Relief from ketamine was brief, and its use was associated with a "wide-eyed" look that was distressing to the family. Ketamine was discontinued and a dexmedetomidine infusion was initiated. The patient's level of comfort improved greatly. The child died peacefully 24 hours after initiating dexmedetomidine from her underlying disease rather than the effects of the sedative.
期刊介绍：
Palliative Care and Social Practice is an international, peer-reviewed, open access journal that publishes articles on all aspects of palliative care. It welcomes articles from symptom science, clinical practice, and health services research. However, its aim is also to publish cutting-edge research from the realm of social practice - from public health theory and practice, social medicine, and social work, to social sciences related to dying and its care, as well as policy, criticism, and cultural studies. We encourage reports from work with under-represented groups, community development, and studies of civic engagement in end of life issues. Furthermore, we encourage scholarly articles that challenge current thinking about dying, its current care models and practices, and current understandings of grief and bereavement. We want to showcase the next generation of palliative care innovation research and practice - in clinics and in the wider society. Relaunched in July 2019. Partnered with Public Health Palliative Care International (PHPCI) (Title 2008-2018: - Palliative Care: Research and Treatment)
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