The first objective of this pilot is to determine the feasibility of the measurements of the blood circulation in patients during the last phase of life. The second objective is to survey the quality of the blood circulation, particularly the…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
Patiënten gedurende de laatste fase van het leven
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
1.The feasibility of the pilot (to determine if the study could be done on
larger scale), determined on three criteria: a. possible practical problems of
measuring, b. the willingness to participate the study, c. reactions to the
measurements of patients and their relatives.
2.An inventory of the course of the blood circulation, measured by four
non-invasive measurement instruments, before and after the recognition of the
dying phase.
Secondary outcome
The relationship of the course of the blood circulation (the pulsatory volume,
the heart rate, blood pressure, cardiac output, systemic vascular resistance,
peripheral perfusion, peripheral oxygenation and perfusion of the
microcirculation) measured through four non-invasive measurement instruments
with clinical signs of the approached death to patients with a life expectancy
of only days.
Background summary
If the death of a patient is unavoidable within a short period (a few days),
further medical interference with the goal to reach life extension is useless
and potentially harmful. In practice this so-called dying phase frequently is
recognized late or is even not recognized. One of the reasons for this
shortcoming is that there is a lack of an objective parameter that could
determine this dying phase. An important reason for this is that there is
hardly any knowledge of the physical process of dying.
A core system of the physiology of the human body is the blood circulation.
During the last years investigation, non-invasive, of the blood circulation is
done frequently in severe ill intensive care patients. It is proven that
particularly the determination of the microcirculation can give valuable
information about the prognosis and clinical outcomes of patients.
Study objective
The first objective of this pilot is to determine the feasibility of the
measurements of the blood circulation in patients during the last phase of
life. The second objective is to survey the quality of the blood circulation,
particularly the microcirculation, during the last phase of life. Dependent on
the outcomes of the pilot further investigation will be done to investigate the
value of measuring the blood circulation in order to determine the dying
phase.
Study design
The pilot will take place during two weeks. All patients who stay at hospice
Cadenza at the start or who will be admitted to the hospice during the first
week of the pilot and where the presumption is that they are not dying (not *in
the dying phase*) will be asked to participate in the pilot. After inclusion
the bloodcirculation will be measured one time (measurement A). In all patients
where the presumption of the physicians and nurses of the hospice during the
two weeks of the pilot is that they will die within a few days the measurement
will be repeated (measurement B). If the concerned patient will not die within
the presumed few days but, during the pilot, the presumption is still that the
patient will die within a few days the measurement will be repeated again.
Measurement B will be done at most three times. In total, measurement A and B,
the measurement of the blood circulation will be done four times.
The blood circulation will be measured by four non-invasive measurement
instruments. With this, parameters of the macrocirculation (such as the pulse
rate and the blood pressure) and the microcirculation (oxygenation and
perfusion) will be determined. Beside, more general measurements, such as the
fluid intake of the patient and the determination of the Karnofsky score, will
be measured.
Study burden and risks
Because the determination of the blood circulation (micro- and macirculation)
will be done by means of non-invasive measurements the physical load is
minimally. However, the approaching death is accompanied with many distressed
feelings by which participation to the pilot could produce an emotional
reaction to the included patients and their relatives. We will verify this
carefully.
's-Gravendijkwal 230
Rotterdam 3015 CE
NL
's-Gravendijkwal 230
Rotterdam 3015 CE
NL
Listed location countries
Age
Inclusion criteria
1. Estimated life expectancy of three months or less
2. Age >= 18 years
Exclusion criteria
1. Insufficient understanding of the Dutch language
2. Functional disorders (for example severe dementia or delirium)
3. Great oral cavity defect as a result of a (treatment of) malignancy
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL41525.078.12 |