Intensive and Critical Care Nursing
Volume 22, Issue 4 , Pages 214-219 , August 2006

‘Death rattle’ after withdrawal of mechanical ventilation: Practical and ethical considerations

,Accepted 13 June 2005.

References 

  1. Anonymous . Scopolamine: new preparations. Reference treatment for death rattle. Prescrire Int. 2001;10:99–101
  2. Back IN, Jenkins K, Blower A, Beckhelling J. A study comparing hyoscine hydrobromide and glycopyrrolate in the treatment of death rattle. Palliat Med. 2001;15:329–336
  3. Bennett M, Lucas V, Brennan M, Hughes A, O’Donnell V, Wee B. Using anti-muscarinic drugs in the management of death rattle: evidence-based guidelines for palliative care. Palliat Med. 2002;16:369–374
  4. Bercovitch M, Waller A, Adunsky A. High dose morphine use in hospice setting. A database survey of patient characteristics and effect on life expentancy. Cancer. 1999;86:871–877
  5. Bercovitch M, Adunsky A. Patterns of high-dose morphine in a home-care hospice servive. Cancer. 2004;101:1473–1477
  6. Carlet J, Thijs LG, Antonelli M, Cassell J, Cox P, Hill N, et al. Challenges in end-of-life care in the ICU. In: Statement of the 5th International Consensus Conference in Critical Care. Intensive Care Med 2004;30:770–84.
  7. Cavenaugh TA. The ethics of death-hastening or death-causing palliative analgesic administration to the terminally ill. J Pain Symptom Mange. 1996;12:248–254
  8. Chan JD, Treece PD, Engelberg RA, Crowley L, Rubenfeld GD, Steinberg KP, et al. Narcotic and benzodiazepine use after withdrawal of life support. Association with time of death?. Chest. 2004;126:286–293
  9. Cook D, Rocker G, Heyland D. Dying in the ICU: strategies that may improve end-of-life care. Can J Anesth. 2004;51:266–272
  10. In:  Curtis JR,  Rubenfeld GD editor. Managing death in the intensive care unit. The transition from cure to comfort. Oxford University Press; 2001;
  11. Dawson HR. The use of transdermal scopolamine in the control of death rattle. J Palliat Care. 1989;5:31–33
  12. Ellershaw JE, Sutcliffe JM, Saunders CM. Dehydration and the dying patient. J Pain Symptom Manage. 1995;10:192–197
  13. Engström Å, Söderberg S. The experience of partners of critically ill persons in an intensive care unit. Intensive Crit Care Nurs. 2004;20:299–308
  14. Fohr SA. The double effect of pain medication: separating myth from reality. J Palliat Med. 1998;1:315–328
  15. Hawryluck LA, Harvey WRC, Limieux-Charles L, Singer PA. Consensus guidelines on analgesia and sedation in dying intensive care unit patients. BMC Med Ethics. 2002;3:3
  16. Husebø BS. Palliativmedizin—auch in hohen Alter ?. Schmerz. 2001;15:350–356
  17. Hughes AC, Wilcock A, Corcoran R. Management of “death rattle”. J Pain Symptom Manage. 1996;12:271–272
  18. Kåss RM, Ellershaw J. Respiratory tract secretions in the dying patient: a retrospective study. J Pain Symptom Manage. 2003;26:897–902
  19. Kelly L, O’Driscoll T. The occasional palliative care patient: lessons we have learned. Can J Rural Med. 2004;9:253–256
  20. Lichter I, Hunt E. The last 48 hours of life. J Palliat Care. 1990;7:7–15
  21. Macleod AD. Neurogenic pulmonary edema in palliative care. J Pain Symptom Manage. 2002;23:154–156
  22. Morita T, Tsunoda J, Inoue S. Contributing factors to physical symptoms in terminally-ill cancer patients. J Pain Symptom Manage. 1999;18:338–346
  23. Morita T, Tsunoda J, Inoue S, Chihara S. Risk factors for death rattle in terminally ill cancer patients: a prospective exploratory study. Palliat Med. 2000;14:19–23
  24. Morita T, Tsunoda J, Inoue S, Chihara S. Effects of high dose opioids and sedatives on survival in terminally ill cancer patients. J Pain Symptom Manage. 2001;21:282–289
  25. Morita T, Hyodo I, Yoshimi T, Ikenaga M, Tamura Y, Yoshizawa A, et al. Incidence and underlying etiologies of bronchial secretion in terminally ill cancer patients: a multicenter, prospective, observational study. J Pain Symptom Manage. 2004;27:533–539
  26. Morita T, Hirai K, Sakaguchi Y, Tsuneto S, Shima Y. Family perceived distress about appetite loss and bronchial secretion in the terminal phase. J Pain Symptom Manage. 2004;27:98–99
  27. Murtagh FEM, Thorns A, Oliver DJ. Hyoscine and glycopyrrolate for death rattle. Palliat Med. 2002;16:449
  28. Pochard F, Azoulay E, Chevret S. Symptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity. Crit Care Med. 2001;29:1893–1897
  29. Quevedo F, Walsh D. Morphine-induced ventilatory failure after spinal cord compression. J Pain Symptom Manage. 1999;18:140–142
  30. Rocker GM, Heyland DK, Cook DJ, Dodek PM, Kutsogiannis DJ, O’Callaghan CJ. Most critically ill patients are perceived to die in comfort during withdrawal of life support: a Canadian multicentre study. Can J Anesth. 2004;51:623–630
  31. Rousseau P. Nonpain symptom management in the dying patient. Hosp Physician. 2002;51–56
  32. Saito R. Palliative care and supportive therapy for lung cancer patients. JMAJ. 2003;46:559–564
  33. Shafer A. Complications of sedation with midazolam in the intensive care unit and a comparison with other sedative regimens. Crit Care Med. 1998;26:947–956
  34. Spiess JL, Scott SD. Anticholinergic agents for the treatment of ‘death rattle’ in patients with myasthenia gravis. J Pain Symptom Manage. 2003;26:684–686
  35. Steinhauser KE, Christakis NA, Clipp EC. Factors considered important at the end of life by patients, family, physicians, and other care providers. J Am Med Assoc. 2000;284:2476–2482
  36. Sykes N, Thorns A. Sedative use in the last week of life and the implications for end-of-life decision making. Arch Intern Med. 2003;163:341–344
  37. Sykes N, Thorns A. The use of opioids and sedatives at the end of life. Lancet Oncol. 2003;4:312–318
  38. Thorns A, Sykes N. Opioid use in last week of life and implications for end-of-life decision-making. Lancet. 2000;356:398–399
  39. Truog RD, Cist AFM , Brackett SE. Recommendations for end-of-life care in the intensive care unit: the Ethics Committee of the Society of Critical Care Medicine. Crit Care Med. 2001;29:2332–2348
  40. Twycross R, Lichter I. The terminal phase. In:  Doyle D,  Hanks GWC,  MacDonald N editor. Oxford textbook of palliative medicine. Oxford: Oxford University Press; 1998;p. 985
  41. Twycross R, Lichter I. The terminal phase. In:  Doyle D,  Hanks GWC,  MacDonald N editor. Oxford textbook of palliative medicine. Oxford: Oxford University Press; 1998;p. 981
  42. Voltz R, Borasio GD. Palliative therapy in the terminal stage of neurological disease. J Neurol. 1997;244(Suppl. 4):S2–S10
  43. In:  Voltz R,  Bernat JL,  Borasio GD,  Maddocks I,  Oliver D,  Portenoy RK editor. Palliative care in neurology. Oxford: Oxford University Press; 2004;
  44. Walsh TD. Prevention of opioid side effects. J Pain Symptom Manage. 1990;5:362–367
  45. Watts T, Jenkins K. Palliative care nurses feelings about death rattle. J Clin Nurs. 1999;8:615–618
  46. Wildiers H, Menten J. Death rattle: prevalence, prevention and treatment. J Pain Symptom Manage. 2002;23:310–317

PII: S0964-3397(05)00074-1

doi: 10.1016/j.iccn.2005.06.004

Intensive and Critical Care Nursing
Volume 22, Issue 4 , Pages 214-219 , August 2006