At end of life, oral fluid intake is often reduced. Consensus about the most appropriate management of this situation is lacking. The objective of this Dutch study is to investigate to what extent the amount of fluid intake, preceding and during the dying phase is related to the occurrence of death rattle and restlessness. 371 patients were included in the study. Death rattle was reported at least once in 149 (40%) of patients but not associated with the amount of fluid intake during the days before dying. Terminal restlessness was reported in 96 (26%) of patients. It wasn't associated with a lower amount of fluid intake in the days before dying, however terminal restlessness during the last 24 hours of life was associated with a higher amount of fluid during 48 - 25 hours before death. The authors conclude that a higher amount of fluid (>250mL/day) during 48 - 25 hours before death may be associated with the occurrence of terminal restlessness.
Lokkers, M. et al. 2019. Hydration and symptoms in the last days of life. BMJ Supportive & Palliative Care, epub ahead of print. August 2019/.
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