N J H Raijmakers1, L van Zuylen2, M Costantini3, A Caraceni4, J Clark5, G Lundquist6, R Voltz7, J E Ellershaw8, A van der Heide9. 1. Department of Public Health; Department of Medical Oncology, Erasmus MC, Rotterdam, The Netherlands. Electronic address: n.raijmakers@erasmusmc.nl. 2. Department of Medical Oncology, Erasmus MC, Rotterdam, The Netherlands. 3. Department of Regional Palliative Care Network, National Cancer Research Institute, Genoa. 4. Department of Palliative Care Pain, Therapy and Rehabilitation, National Cancer Institute, Milan, Italy. 5. Education and Research Unit, Arohanui Hospice, Palmerston North, New Zealand. 6. Department of Palliative Home Care, Ludvika, Sweden. 7. Department of Palliative Medicine; Center for Integrated Oncology Cologne/Bonn, University Hospital of Cologne, Cologne, Germany. 8. Marie Curie Palliative Care Institute, University of Liverpool, UK. 9. Department of Public Health.
Abstract
BACKGROUND: The benefits and burdens of artificial nutrition (AN) and artificial hydration (AH) in end-of-life care are unclear. We carried out a literature review on the use of AN and AH in the last days of life of cancer patients. MATERIALS AND METHODS: We systematically searched for papers in PubMed, CINAHL, PsycInfo and EMBASE. All English papers published between January 1998 and July 2009 that contained data on frequencies or effects of AN or AH in cancer patients in the last days of life were included. RESULTS: Reported percentages of patients receiving AN or AH in the last week of life varied from 3% to 53% and from 12% to 88%, respectively. Five studies reported on the effects of AH: two found positive effects (less chronic nausea, less physical dehydration signs), two found negative effects (more ascites, more intestinal drainage) and four found also no effects on terminal delirium, thirst, chronic nausea and fluid overload. No study reported on the sole effect of AN. CONCLUSIONS: Providing AN or AH to cancer patients who are in the last week of life is a frequent practice. The effects on comfort, symptoms and length of survival seem limited. Further research will contribute to better understanding of this important topic in end-of-life care.
BACKGROUND: The benefits and burdens of artificial nutrition (AN) and artificial hydration (AH) in end-of-life care are unclear. We carried out a literature review on the use of AN and AH in the last days of life of cancerpatients. MATERIALS AND METHODS: We systematically searched for papers in PubMed, CINAHL, PsycInfo and EMBASE. All English papers published between January 1998 and July 2009 that contained data on frequencies or effects of AN or AH in cancerpatients in the last days of life were included. RESULTS: Reported percentages of patients receiving AN or AH in the last week of life varied from 3% to 53% and from 12% to 88%, respectively. Five studies reported on the effects of AH: two found positive effects (less chronic nausea, less physical dehydration signs), two found negative effects (more ascites, more intestinal drainage) and four found also no effects on terminal delirium, thirst, chronic nausea and fluid overload. No study reported on the sole effect of AN. CONCLUSIONS: Providing AN or AH to cancerpatients who are in the last week of life is a frequent practice. The effects on comfort, symptoms and length of survival seem limited. Further research will contribute to better understanding of this important topic in end-of-life care.
Authors: Eefje M Sizoo; H Roeline W Pasman; Linda Dirven; Christine Marosi; Wolfgang Grisold; Günther Stockhammer; Jonas Egeter; Robin Grant; Susan Chang; Jan J Heimans; Luc Deliens; Jaap C Reijneveld; Martin J B Taphoorn Journal: Support Care Cancer Date: 2013-12-14 Impact factor: 3.603