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- W2036292515 abstract "Parmi les décisions de fin de vie, l’arrêt de la nutrition et de l’hydratation est une des plus controversée, de part son intentionnalité (celle de provoquer la mort), sa finalité (la dénutrition et la déshydratation) et des représentations que l’on s’en fait. Nous rapportons ici les mécanismes physiopathologiques ainsi que la sémiologie clinique faisant suite à une telle décision. Paradoxalement, la souffrance du patient n’apparaît pas au premier plan au regard de la souffrance morale de l’entourage. Il semble indispensable de noter cette composante avant d’envisager une telle décision. Par ailleurs, deux écueils doivent être connus : la poursuite d’une alimentation orale a minima est délétère, comme la prescription d’opioïdes, telle la morphine, du fait de ses effets toxiques en cas d’insuffisance rénale. One of the most controversial decisions in the end-of-life situation is the withdrawal of nutrition and hydration because of concerns about the intention (provoke death) and the impact (malnutrition, dehydration) and their representations. We recall here the pathophysiological mechanisms involved and the clinical manifestations observed after withdrawal of nutrition and hydration. Paradoxically, the patient's suffering does not appear to be the primary concern but rather the moral suffering of the family. This element should always be noted before considering withdrawal. Two other elements are also noteworthy: continuing oral nutrition at a minimal rate is deleterious, as is the prescription of opioids, because of the toxic effects in the event of kidney failure." @default.
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- W2036292515 date "2008-12-01" @default.
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- W2036292515 title "Physiopathologie et sémiologie de l’arrêt de nutrition et d’hydratation" @default.
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- W2036292515 doi "https://doi.org/10.1016/j.medpal.2008.07.016" @default.
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