Key result
Palliative sedation with dexmedetomidine or midazolam significantly reduced the Richmond Agitation-Sedation Scale (P<0.01) without altering blood pressure or heart rate in terminally ill heart failure patients.
Why the study?
Little is known about palliative sedation in terminally ill heart failure patients.
Does palliative sedation with dexmedetomidine or midazolam reduce agitation in terminally ill heart failure patients?
Cohort (n=95)
No
Does palliative sedation with dexmedetomidine or midazolam reduce agitation in terminally ill heart failure patients?
Absolute Event Rate: -1% vs 1%
p-value: p=<0.01
Palliative sedation with dexmedetomidine or midazolam appears feasible and effectively reduces agitation without compromising hemodynamics in terminally ill heart failure patients.
May support sedation for terminal HF agitation without hemodynamic impact; hypothesis-generating and needs RCTs before practice change.
BACKGROUND: Little is known about palliative sedation in terminally ill heart failure (HF) patients. METHODS AND RESULTS: We retrospectively reviewed terminally ill HF patients who received palliative sedation from September 2013 to August 2018. Among 95 terminally ill HF patients, 25 were prescribed dexmedetomidine and 12 were prescribed midazolam at the end of life. Richmond Agitation-Sedation Scale was significantly reduced (P<0.01), but blood pressure and heart rate were unaltered after treatment in both the dexmedetomidine and midazolam groups. CONCLUSIONS: Prescription of dexmedetomidine and/or midazolam might be feasible in selected terminally ill HF patients.
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Hamatani et al. (2019) conducted a cohort in Terminally ill heart failure (n=95). Palliative sedation (dexmedetomidine or midazolam) vs. Baseline (pre-treatment) was evaluated on Richmond Agitation-Sedation Scale (RASS) (p=<0.01). Palliative sedation with dexmedetomidine or midazolam significantly reduced the Richmond Agitation-Sedation Scale (P<0.01) without altering blood pressure or heart rate in terminally ill heart failure patients.
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