Hyoscine Butylbromide for the Management of Death Rattle: Sooner Rather Than Later

• Sebastiano Mercadante, Franco Marinangeli, Francesco Masedu, et al. J Pain Symptom Manage. 2018;56:902–7.

This open-label study compared the use of hyoscine butylbromide prophylactically in dying patients with a reduced level of consciousness (n= 51) versus giving hyoscine butylbromide to dying patients only once they developed noisy respiratory tract secretions (n=81). Patients were administered 20 mg of hyoscine butylbromide as a subcutaneous or intravenous bolus, followed by 60 mg/24 hours. In patients who were given prophylactic hyoscine butylbromide, 5.9 % developed death rattle while 60.5 % had death rattle in the group who were given hyoscine butylbromide once death rattle was established. There was a significant difference for the onset of death rattle in both groups (median time 12 hours vs 36 hours in the …