JAMA Network JAMA Oncology : Proportional Sedation for Persistent Agitated Delirium in Palliative Care
Jul 31, 2025
In this insightful discussion, David Hui, a leading authority in palliative care from the University of Texas MD Anderson Cancer Center, and Eduardo Bruera, a renowned expert in delirium management, delve into their groundbreaking study on agitated delirium in cancer patients. They discuss innovative sedation strategies tailored for terminal patients, the emotional toll of delirium on families, and the need for personalized care. Their findings emphasize the importance of teamwork in palliative care and call for future research to enhance patient outcomes and support.
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Delirium in End-of-Life Care
- Delirium at the end of life is a progressive brain failure affecting up to 90% of cancer patients near death.
- It causes severe distress for patients, families, and clinicians due to agitation and confusion.
RECARD Study Design Insight
- The RECARD study addresses suffering in patients near death with persistent agitation.
- Including a placebo group was essential to scientifically evaluate medication effectiveness.
Sedation Focus in End-Stage Delirium
- In final days, sedation aims to reduce distress, not delirium itself.
- Lorazepam with haloperidol reduced agitation better than haloperidol alone, improving comfort.