Martine E Lokker1, Lia van Zuylen2, Carin C D van der Rijt2, Agnes van der Heide3. 1. Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands; Department of Medical Oncology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. Electronic address: m.lokker@erasmusmc.nl. 2. Department of Medical Oncology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands. 3. Department of Public Health, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
Abstract
CONTEXT: Death rattle, or respiratory tract secretion in the dying patient, is a common and potentially distressing symptom in dying patients. Health care professionals often struggle with this symptom because of the uncertainty about management. OBJECTIVES: To give an overview of the current evidence on the prevalence of death rattle in dying patients, its impact on patients, relatives, and professional caregivers, and the effectiveness of interventions. METHODS: We systematically searched the databases PubMed, Embase, CINAHL, PsychINFO, and Web of Science. English-language articles containing original data on the prevalence or impact of death rattle or on the effects of interventions were included. RESULTS: We identified 39 articles, of which 29 reported on the prevalence of death rattle, eight on its impact, and 11 on the effectiveness of interventions. There is a wide variation in reported prevalence rates (12%-92%; weighted mean, 35%). Death rattle leads to distress in both relatives and professional caregivers, but its impact on patients is unclear. Different medication regimens have been studied, that is, scopolamine, glycopyrronium, hyoscine butylbromide, atropine, and/or octreotide. Only one study used a placebo group. There is no evidence that the use of any antimuscarinic drug is superior to no treatment. CONCLUSION: Death rattle is a rather common symptom in dying patients, but it is doubtful if patients suffer from this symptom. Current literature does not support the standard use of antimuscarinic drugs in the treatment of death rattle.
CONTEXT: Death rattle, or respiratory tract secretion in the dying patient, is a common and potentially distressing symptom in dying patients. Health care professionals often struggle with this symptom because of the uncertainty about management. OBJECTIVES: To give an overview of the current evidence on the prevalence of death rattle in dying patients, its impact on patients, relatives, and professional caregivers, and the effectiveness of interventions. METHODS: We systematically searched the databases PubMed, Embase, CINAHL, PsychINFO, and Web of Science. English-language articles containing original data on the prevalence or impact of death rattle or on the effects of interventions were included. RESULTS: We identified 39 articles, of which 29 reported on the prevalence of death rattle, eight on its impact, and 11 on the effectiveness of interventions. There is a wide variation in reported prevalence rates (12%-92%; weighted mean, 35%). Death rattle leads to distress in both relatives and professional caregivers, but its impact on patients is unclear. Different medication regimens have been studied, that is, scopolamine, glycopyrronium, hyoscine butylbromide, atropine, and/or octreotide. Only one study used a placebo group. There is no evidence that the use of any antimuscarinic drug is superior to no treatment. CONCLUSION:Death rattle is a rather common symptom in dying patients, but it is doubtful if patients suffer from this symptom. Current literature does not support the standard use of antimuscarinic drugs in the treatment of death rattle.
Authors: Harriëtte J van Esch; Lia van Zuylen; Eric C T Geijteman; Esther Oomen-de Hoop; Bregje A A Huisman; Heike S Noordzij-Nooteboom; Renske Boogaard; Agnes van der Heide; Carin C D van der Rijt Journal: JAMA Date: 2021-10-05 Impact factor: 56.272
Authors: Aaron K Wong; Lucy Demediuk; Jia Y Tay; Olivia Wawryk; Anna Collins; Rachel Everitt; Jennifer Philip; Kirsty Buising; Brian Le Journal: Intern Med J Date: 2021-09 Impact factor: 2.611
Authors: Harriëtte J van Esch; Lia van Zuylen; Esther Oomen-de Hoop; Agnes van der Heide; Carin C D van der Rijt Journal: BMC Palliat Care Date: 2018-09-07 Impact factor: 3.234
Authors: Emily M Ellsworth; Kevin J Bacigalupo; Kavita R Palla; Seema S Limaye; Margaret J Walkosz; Sandra T Szczecinski; Katie J Suda Journal: Fed Pract Date: 2021-05
Authors: Harriëtte J van Esch; Martine E Lokker; Judith Rietjens; Lia van Zuylen; Carin C D van der Rijt; Agnes van der Heide Journal: BMC Psychol Date: 2020-06-12