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Hospice and Palliative Medicine Clinician Views of Deactivation of Ventricular Assist Devices at End of Life
Left ventricular assist devices (LVADs) provide circulatory support to patients with advanced heart failure. These devices are used as a temporary bridge to recovery, bridge to cardiac transplantation, or as destination therapy (DT)—where the patient will have the device in situ for the remainder of his/her life. Compared to medical management alone, LVAD-DT often improves survival and quality of life for patients with severe heart failure.1 However, patients with LVADs may experience a host of challenges including a catastrophic event (e.g., stroke, hemorrhage, infection), a concurrent slow decline in health (e.g., righ...
Source: Journal of Pain and Symptom Management - May 26, 2015 Category: Palliative Care Authors: Keith M. Swetz, Sara E. Wordingham, Matthew H. Armstrong, Katlyn E. Koepp, Abigale L. Ottenberg Source Type: research

Hospice and Palliative Medicine Clinician Views of Deactivation of Ventricular Assist Devices at the End of Life
Left ventricular assist devices (LVADs) provide circulatory support to patients with advanced heart failure. These devices are used as a temporary bridge to recovery, bridge to cardiac transplantation, or as destination therapy (DT)—where the patient will have the device in situ for the remainder of his/her life. Compared to medical management alone, LVAD-DT often improves survival and quality of life for patients with severe heart failure.1 However, patients with LVADs may experience a host of challenges including a catastrophic event (e.g., stroke, hemorrhage, infection), a concurrent slow decline in health (e.g., righ...
Source: Journal of Pain and Symptom Management - May 26, 2015 Category: Palliative Care Authors: Keith M. Swetz, Sara E. Wordingham, Matthew H. Armstrong, Katlyn E. Koepp, Abigale L. Ottenberg Tags: Letter Source Type: research

Subcutaneous Use of Baclofen
Painful spasticity is an often debilitating symptom that occurs mostly in patients with neurologic diseases such as multiple sclerosis or stroke. Treatment approaches include pharmacologic and nonpharmacologic interventions. Baclofen is one of the drugs commonly used to decrease elevated muscle tone. This GABAB agonist acts primarily by limiting the release of excitatory neurotransmitters on the spinal level, thereby decreasing spastic muscle tone. Baclofen is licensed for oral and intrathecal use in spasticity. The abrupt cessation of baclofen therapy can lead to withdrawal syndromes including epileptic seizures. Here, we...
Source: Journal of Pain and Symptom Management - May 30, 2014 Category: Palliative Care Authors: Constanze Rémi, Elisabeth Albrecht Tags: Letters Source Type: research

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