Rogier van Deijck Continuous palliative sedation: determinants, practice and outcome

Date of PhD defense:  15 March 2017
Institute: RIHS, Radboud Institute for Health Sciences
Promotor: Prof. Raymond Koopmans (Primary and Community Care), Prof. Kris Vissers (Anesthesiology, Pain Medicine and Palliative Care)
Co-promotors: Dr Stans Verhagen (Medical Oncology), Dr Jeroen Hasselaar (Anesthesiology, Pain Medicine and Palliative Care)
The results of the study show that Continuous palliative sedation (CPS) appears to be an effective intervention for refractory symptoms in the final days of a patient’s life. However, the administration of CPS should be considered as a palliative intervention of last resort. Additionally, CPS is not a one-size-fits-all intervention because some sedated patients still experienced higher levels of discomfort in the last hours of life. Therefore, both in clinical practice as well as in the national guideline on palliative sedation, more awareness for monitoring for signs of opioid toxicity, the presence and intensity of delirium, pain, dyspnea and feelings of hopelessness should be present in patients in the palliative trajectory. Adequate palliative care with careful assessment of potential reversible factors and non-sedating interventions should be the cornerstone of treatment before starting palliative sedation. Effective interventions in these patients could possibly prevent a refractory state for such symptoms, thereby possibly limiting the future need for CPS.

Biography

Rogier van Deijck (1972) studied medicine at Radboud University. Subsequently he graduated as an elderly care physician in 2002. He carried out the research described above at the Department of Primary Care and the Department of Anesthesiology, Pain and Palliative Medicine at Radboud university medical center. He combined the research with his work as an elderly care specialist at De Zorggroep, where he has been employed since 1998.

Rogier van Deijck