From research to reality: A review of three clinical problems in the last days of life

All of us will one day die. For most of us, death will be anticipated, usually following a period of ill health. The opportunity to anticipate and manage clinical conditions associated with the agonal process is an essential part of advance care planning.Guidelines exist for the palliation of most s...

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Main Authors: Tasneem Wadee, Simon Noble
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1470211825002040
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author Tasneem Wadee
Simon Noble
author_facet Tasneem Wadee
Simon Noble
author_sort Tasneem Wadee
collection DOAJ
description All of us will one day die. For most of us, death will be anticipated, usually following a period of ill health. The opportunity to anticipate and manage clinical conditions associated with the agonal process is an essential part of advance care planning.Guidelines exist for the palliation of most symptomatic events at the end of life, although many recommendations are based on low-quality evidence or consensus. Furthermore, when potentially practice-changing data emerge, there is an inevitable lag time before clinical practice changes.In this paper, we shall discuss the management of three challenging scenarios faced by teams looking after patients at the end of life: delirium, terminal haemorrhage and noisy upper airway secretions. We aim to critically evaluate the utility of current evidence, pharmacological and non-pharmacological, and how it translates into clinical practice.
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spelling doaj-art-0b1c2fa64bea4b8bb0dbafcc69caf04b2025-08-20T03:59:37ZengElsevierClinical Medicine1470-21182025-07-0125410048610.1016/j.clinme.2025.100486From research to reality: A review of three clinical problems in the last days of lifeTasneem Wadee0Simon Noble1Internal Medicine Trainee, Aneurin Bevan University Health Board, Gwent, Wales, UKSupportive and Palliative Medicine, Cardiff University, Cardiff, Wales, UK; Corresponding author.All of us will one day die. For most of us, death will be anticipated, usually following a period of ill health. The opportunity to anticipate and manage clinical conditions associated with the agonal process is an essential part of advance care planning.Guidelines exist for the palliation of most symptomatic events at the end of life, although many recommendations are based on low-quality evidence or consensus. Furthermore, when potentially practice-changing data emerge, there is an inevitable lag time before clinical practice changes.In this paper, we shall discuss the management of three challenging scenarios faced by teams looking after patients at the end of life: delirium, terminal haemorrhage and noisy upper airway secretions. We aim to critically evaluate the utility of current evidence, pharmacological and non-pharmacological, and how it translates into clinical practice.http://www.sciencedirect.com/science/article/pii/S1470211825002040Terminal deliriumDeliriumTerminal haemorrhageSecretionsTerminal secretionsEnd of life care
spellingShingle Tasneem Wadee
Simon Noble
From research to reality: A review of three clinical problems in the last days of life
Clinical Medicine
Terminal delirium
Delirium
Terminal haemorrhage
Secretions
Terminal secretions
End of life care
title From research to reality: A review of three clinical problems in the last days of life
title_full From research to reality: A review of three clinical problems in the last days of life
title_fullStr From research to reality: A review of three clinical problems in the last days of life
title_full_unstemmed From research to reality: A review of three clinical problems in the last days of life
title_short From research to reality: A review of three clinical problems in the last days of life
title_sort from research to reality a review of three clinical problems in the last days of life
topic Terminal delirium
Delirium
Terminal haemorrhage
Secretions
Terminal secretions
End of life care
url http://www.sciencedirect.com/science/article/pii/S1470211825002040
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