Management of Terminal Hemorrhage in Patients With Advanced Cancer: A Systematic Literature Review

摘要: Although terminal hemorrhage is an infrequent occurrence in advanced cancer patients, it extremely distressing for their families, and health care professionals when does occur. By definition, there a very short time period to support comfort the patient, vital that management approach follows best available evidence base. A systematic literature search was carried out retrieve relevant publications relating of patients with whom invasive or interventional procedures are no longer appropriate. From 3,564 initial citations, 18 were appropriate include final review, many which focused on head neck tumors. The reported incidence significant bleeding 6%-14% 3%-12%. Key areas arising from 1) identifying at risk, 2) general supportive measures use, 3) use sedative medication. General included dark towels camouflage blood loss, suction, applying external pressure. There variation recommended medication (drug, dose, route). Drugs diazepam, midazolam, diamorphine, ketamine varying doses routes administration. Current guidelines based completely isolated case reports expert opinion. Clinical research needed this area but difficult because practical ethical limitations.