{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T04:24:25Z","timestamp":1791865465790,"version":"4.3.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T00:00:00Z","timestamp":1686528000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Continuous and deep sedation until death is a much highly debated end-of-life practice. France is unique in having a regulatory framework for it. However, there are no data on its practice in intensive care units (ICUs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>The aim is to describe continuous and deep sedation in relation to the framework in the specific context of withdrawal of life-sustaining therapies in ICUs, that is, its decision-making process and its practice compared to other end-of-life practices in this setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and setting:<\/jats:title>\n                    <jats:p>French multicenter observational study. Consecutive ICU patients who died after a decision to withdraw life-sustaining therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 343 patients in 57 ICUs, 208 (60%) with continuous and deep sedation. A formalized procedure for continuous and deep sedation was available in 32% of the ICUs. Continuous and deep sedation was not the result of a collegial decision-making process in 17% of cases, and did not involve consultation with an external physician in 29% of cases. The most commonly used sedative medicines were midazolam (10 [5\u201318] mg\u2009h\n                      <jats:sup>\u22121<\/jats:sup>\n                      ) and propofol (200 [120\u2013250] mg\u2009h\n                      <jats:sup>\u22121<\/jats:sup>\n                      ). The Richmond Agitation Sedation Scale (RASS) was \u22125 in 60% of cases. Analgesia was associated with sedation in 94% of cases. Compared with other end-of-life sedative practices ( n\u2009=\u200998), medicines doses were higher with no difference in the depth of sedation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study shows a poor compliance with the framework for continuous and deep sedation. It highlights the need to formalize it to improve the decision-making process and the match between the intent, the practice and the actual effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163231180656","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T05:17:29Z","timestamp":1686547049000},"page":"1202-1209","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Continuous and deep sedation until death after a decision to withdraw life-sustaining therapies in intensive care units: A national survey"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9307-1913","authenticated-orcid":false,"given":"Matthieu","family":"Le Dorze","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, DMU PARABOL, Lariboisi\u00e8re Hospital, AP-HP Nord, Paris, France"},{"name":"Universit\u00e9 Paris-Saclay, CESP U1018, Inserm, Paris, France"},{"name":"Universit\u00e9 de Paris, UMR-S 942 (MASCOT), Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6493-4326","authenticated-orcid":false,"given":"Romain","family":"Barth\u00e9l\u00e9my","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, DMU PARABOL, Lariboisi\u00e8re Hospital, AP-HP Nord, Paris, France"},{"name":"Universit\u00e9 de Paris, UMR-S 942 (MASCOT), Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhael","family":"Giabicani","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care, AP-HP, Beaujon Hospital, Paris, France"},{"name":"Sorbonne Universit\u00e9, Inserm, Centre de Recherche des Cordeliers, Laboratoire ETREs, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Audibert","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Critical Care Medicine, CHRU Nancy, Universit\u00e9 de Lorraine, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Cousin","sequence":"additional","affiliation":[{"name":"Centre national des soins palliatifs et de la fin de vie (CNSPFV), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9ment","family":"Gakuba","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9","family":"Robert","sequence":"additional","affiliation":[{"name":"M\u00e9decine Intensive R\u00e9animation, CHU Poitiers, F-86000, Poitiers, France"},{"name":"Universit\u00e9 de Poitiers, CIC Inserm ALIVE, F-86000, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Chousterman","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, DMU PARABOL, Lariboisi\u00e8re Hospital, AP-HP Nord, Paris, France"},{"name":"Universit\u00e9 de Paris, UMR-S 942 (MASCOT), Inserm, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Fran\u00e7ois","family":"Perrigault","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, Gui de Chauliac University Hospital, Universit\u00e9 de Montpellier, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"The SFAR Research Network and The SEDALAT-REA-Group*","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,12]]},"reference":[{"key":"bibr1-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1177\/0269216309107024"},{"issue":"3","key":"bibr2-02692163231180656","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1136\/bmjspcare-2016-001159","volume":"7","author":"Abarshi E","year":"2017","journal-title":"BMJ Support Palliat Care"},{"key":"bibr3-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-4011-2"},{"key":"bibr4-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2017-104484"},{"key":"bibr5-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2019.07.008"},{"key":"bibr6-02692163231180656","unstructured":"Haute Autorit\u00e9 de Sant\u00e9. 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Available at: www.has-sante.fr\/jcms\/c_2832000\/fr\/comment-mettre-en-oeuvre-une-sedation-profonde-et-continue-maintenue-jusqu-au-deces (2020, accessed 1 June 2023)."},{"key":"bibr8-02692163231180656","first-page":"1","volume":"12","author":"Twycross R","year":"2019","journal-title":"Palliat Care"},{"key":"bibr9-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1080\/15360288.2017.1279502"},{"key":"bibr10-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70032-4"},{"key":"bibr11-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-014-2200-9"},{"key":"bibr12-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.03.008"},{"key":"bibr13-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2018.05.018"},{"key":"bibr14-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.14608"},{"key":"bibr15-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0B013E3181659096"},{"key":"bibr16-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003975"},{"key":"bibr17-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-06139-7"},{"key":"bibr18-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-020-05930-w"},{"key":"bibr19-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1208795"},{"key":"bibr20-02692163231180656","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202112-2787ED"},{"key":"bibr21-02692163231180656","unstructured":"Article 37-2 - Limitation ou arr\u00eat de traitement. 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