{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T07:11:45Z","timestamp":1778915505692,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"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":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is a lack of evidence to guide the administration of phenobarbital for managing refractory symptoms in paediatric palliative care patients at home during the terminal phase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>Three terminal home-based paediatric cases with refractory symptoms that caused significant distress to both the child and family during the final days of life. All three cases had several changes in medications before receiving phenobarbital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case management:<\/jats:title>\n                    <jats:p>The first case had a loading dose of phenobarbital based on an adult guideline; the second case commenced a continuous phenobarbital infusion without a loading dose of phenobarbital; and the final case had a weight-based loading dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case outcome:<\/jats:title>\n                    <jats:p>In the absence of paediatric clinical guidelines for the use of phenobarbital in refractory symptom management, a weight-based loading dose of phenobarbital before commencing a continuous infusion provided enhanced symptom management when compared with a loading dose using adult guidance or the absence of one.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Further research is needed on the administration of a loading dose of phenobarbital for managing terminal refractory symptoms in the paediatric palliative care population during the terminal phase. This will help to establish evidence-based guidelines for paediatric palliative sedation, ensuring appropriate relief of refractory symptoms for a peaceful death at home.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163251395457","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T04:57:31Z","timestamp":1764651451000},"page":"265-272","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Loading phenobarbital in paediatric home-based terminal care: A case series"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6502-104X","authenticated-orcid":false,"given":"Jo-Anne J.","family":"Kelly","sequence":"first","affiliation":[{"name":"Palliative Care South East, Narre Warren, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2460-7025","authenticated-orcid":false,"given":"Karen Aisling","family":"Griffin","sequence":"additional","affiliation":[{"name":"Palliative Care South East, Narre Warren, VIC, Australia"},{"name":"Peninsula Health, Frankston, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1900-4557","authenticated-orcid":false,"given":"Sidharth","family":"Vemuri","sequence":"additional","affiliation":[{"name":"Victorian Paediatric Palliative Care Program, Royal Children\u2019s Hospital, Parkville, VIC, Australia"},{"name":"Monash Children\u2019s Hospital, Clayton, VIC, Australia"},{"name":"Murdoch Children\u2019s Research Institute, Parkville, VIC, Australia"},{"name":"The University of Melbourne, Parkville, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6386-5966","authenticated-orcid":false,"given":"Bronwyn","family":"Sacks","sequence":"additional","affiliation":[{"name":"Victorian Paediatric Palliative Care Program, Royal Children\u2019s Hospital, Parkville, VIC, Australia"},{"name":"Monash Children\u2019s Hospital, Clayton, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4288-7394","authenticated-orcid":false,"given":"Susan","family":"Lee","sequence":"additional","affiliation":[{"name":"Palliative Care South East, Narre Warren, VIC, Australia"},{"name":"Monash University, Clayton, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002761"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114555157"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3747\/co.21.1773"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(99)00006-8"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.09.022"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000522558"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2017-001366"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.31128\/AJGP-05-19-4938"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.04.019"},{"key":"e_1_3_2_11_2","unstructured":"Safer Care Victoria. Palliative sedation therapy Statewide Guidance for Victoria www.safercare.vic.gov.au\/best-practice-improvement\/clinical-guidance\/palliative\/palliative-sedation-therapy (2020 accessed 03 May 2024)."},{"key":"e_1_3_2_12_2","unstructured":"NSW Government. Subcutaneous phenobarbital (S4D) for refractory terminal agitation and uncontrolled seizures (including status epilepticus) in the imminently dying patient. SESLHDMG\/129 - Medicine Guideline (2020 accessed 03 May 2024)."},{"key":"e_1_3_2_13_2","unstructured":"Queensland Health. NMedQ21.062-V2-R26 Phenobarbital (phenobarbitone) www.health.qld.gov.au\/qcg (2021 accessed 16 May 2024)."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s005200100235"},{"key":"e_1_3_2_15_2","first-page":"309","volume-title":"Palliative care formulary","author":"Charlesworth S.","year":"2020","unstructured":"Charlesworth S. Palliative care formulary. 7th ed. 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In: Formulary. 6th ed. p.193. www.appm.org.uk (2024 accessed 11 July 2025)."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/resp.14121"}],"container-title":["Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02692163251395457","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02692163251395457","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02692163251395457","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T06:44:53Z","timestamp":1778913893000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02692163251395457"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/02692163251395457"],"URL":"https:\/\/doi.org\/10.1177\/02692163251395457","relation":{},"ISSN":["0269-2163","1477-030X"],"issn-type":[{"value":"0269-2163","type":"print"},{"value":"1477-030X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}