What we do
Continuous palliative sedation until death (CPS), defined as the intentional lowering of consciousness in dying patients to relieve refractory suffering, is frequently applied at the end of life. In 2021, 23% of all deaths in the Netherlands were preceded by CPS. Midazolam is the drug of first choice to achieve sufficient symptom relief through CPS. Due to inter-individual variability in midazolam requirements and a limited scientific basis for initial dosing, dosage is determined through gradual titration and clinical observation. In current practice, however, adequate sedation is not always achieved in a timely manner, with the result that some patients continue to experience symptoms in the final hours before death.
The STATION project consists of several phases, beginning with observational and mixed-methods research that will provide insight into interindividual variability in the response to midazolam and into experiences of healthcare professionals with difficult CPS trajectories. The ultimate goal is to develop a tool to support the pharmacological management of CPS in clinical practice and to evaluate this tool, thereby enabling optimized and individualized use of palliative sedation. To achieve this goal, we are conducting a multicenter clinical trial at Erasmus MC and in various Dutch hospices.
- Palliative care
- Palliative sedation
- Pain and symptom management
- Hospice care
- Clinical pharmacometrics
Collaborations within Erasmus MC Collaborations outside of Erasmus MC
Eric Geijteman
Birgit Koch
Stijn Koolen
Brenda de Winter
Jet van Esch
Merel Noomen
Fleur Dikkeboom
