What is refractory agitation?
The term “refractory” can be applied to symptoms that cannot be adequately controlled despite aggressive efforts to identify a tolerable therapy that does not compromise consciousness.
What is refractory delirium?
Refractory symptom or refractory delirium: a symptom is defined as refractory if it continues to cause distress despite the use all other possible and tolerable symptomatic treatments that do not compromise consciousness.
What is refractory gastrointestinal symptoms?
The symptoms of refractory disease are not unlike those of untreated celiac disease except that they are usually more severe and more disabling. The more common symptoms include weight loss, diarrhea, abdominal pain, malnutrition and anemia.
What are refractory symptoms in heart failure?
Refractory CHF is defined as symptoms of CHF at rest or repeated exacerbations of CHF despite “optimal” triple-drug therapy. Most patients with refractory CHF require hemodynamic monitoring and treatment in the intensive care unit.
When is palliative sedation used?
Palliative sedation may be utilized in both adults and children [2-6] with advanced incurable (ie, terminal) illness in order to alleviate severe symptoms that are refractory to other forms of treatment. It is most commonly utilized for the treatment of refractory pain, dyspnea, agitated delirium, and convulsions.
What does refractory mean in medical terms?
(reh-FRAK-tor-ee) In medicine, describes a disease or condition that does not respond to treatment.
What are intractable symptoms?
A symptom for which all possible treatment has failed, or for which it is estimated that no methods are available for palliation within the time frame for a risk–benefit ratio that the patient can tolerate.
Is refractory celiac disease fatal?
Overall, people with untreated or unresponsive celiac disease have increased early mortality compared to the general population. Without diagnosis and treatment, celiac disease is ultimately fatal in 10 to 30% of people. Currently this outcome is rare, as most people do well if they avoid gluten.
What is refractory gastrointestinal?
Refractory GERD is defined as partial response or lack of response in GERD patients taking PPI twice daily over a period of at least 3 months. It has been estimated that between 10% and 40% of GERD patients fail to respond symptomatically, either partially or completely, to a standard-dose PPI1 (Figure 2).
What is refractory cardiac disease?
What is refractory CHF?
Refractory CHF here is defined as New York Heart Association (NYHA) functional class III-IV heart failure, despite maximal drug therapy. Before such a diagnosis is made, the patient should be treated with digoxin, diuretics, and a vasodilator.
When to use palliative sedation for refractory agitation?
In patients with severe, refractory agitation, palliative sedation may be considered. Palliative sedation is defined as the intentional lowering of awareness toward, and including, unconsciousness for patients with severe and refractory symptoms.
Which is the best definition of a refractory symptom?
A refractory symptom may be subjective and, at times, nonspecific. It is 2007-12-07ot;difficult” symptoms, since many symptoms considered refractory are at times successfully managed by specialized hospice and palliative care programs (Broeckaert 2002).
How is agitation treated in patients with delirium?
The current management of agitation in delirium involves (1) treatment of delirium by identifying and removing any reversible causes, (2) non-pharmacologic measures, and (3) pharmacologic interventions for palliation [19].