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临终喉鸣:是临近死亡的令人安心的预兆,还是循证医学实践中不足之处的典型例子。

Death rattle: reassuring harbinger of imminent death or a perfect example of inadequacies in evidence-based practice.

作者信息

Watts Tessa, Willis Derek, Noble Simon, Johnston Bridget

机构信息

School of Health Care Sciences, Cardiff University, Cardiff.

University of Chester, Chester.

出版信息

Curr Opin Support Palliat Care. 2019 Dec;13(4):380-383. doi: 10.1097/SPC.0000000000000463.

Abstract

PURPOSE OF REVIEW

Death is the inevitable consequence of life. Although clinicians are unlikely to accurately pinpoint when death is likely to occur in the people they care for, the death in a person with a diagnosis of malignant and nonmalignant tends to involve a period of predictable progressive clinical and functional deterioration. During this time, it is common for death rattle to occur. Due to its presentation, death rattle can cause stress and distress to caregivers. This often prompts clinicians to consider medical interventions that are not only ineffective in treating the problem but may also do harm.

RECENT FINDINGS

There is a dearth of research related to the management of death rattle.

SUMMARY

The article discusses the existing evidence in the management of death rattle, considerations for clinicians in the absence of reliable evidence and suggests areas for future research.

摘要

综述目的

死亡是生命不可避免的结果。尽管临床医生不太可能准确指出他们所照顾的患者何时可能死亡,但患有恶性和非恶性疾病的人的死亡往往会经历一段可预测的渐进性临床和功能恶化期。在此期间,临终喉鸣很常见。由于其表现,临终喉鸣会给护理人员带来压力和困扰。这常常促使临床医生考虑一些不仅对治疗该问题无效而且可能有害的医疗干预措施。

最新发现

关于临终喉鸣管理的研究匮乏。

总结

本文讨论了临终喉鸣管理方面的现有证据,在缺乏可靠证据时临床医生应考虑的因素,并提出了未来研究的方向。

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