Abstract：
OBJECTIVE: Death rattle (DR) is a common symptom in dying patients, caused by secretions in the upper airway. Experiences regarding DR differ among patients, relatives, and health professionals. However, evidence of patients\', relatives\', and health professionals\' needs for DR management in order to improve their experiences is lacking. In addition, little is known about the actual effects of non-pharmacological interventions on DR intensity or DR-related distress. This narrative review aims to explore (I) the experiences and needs of patients, relatives, and health professionals regarding DR sound and its management; and (II) studies on non-pharmacological interventions in DR management.
METHODS: Based on a PubMed literature search with the free-text term \"death rattle\", nine studies published in the last ten years were included.
UNASSIGNED: No significant correlation between DR intensity and patients\' respiratory distress could be found. Some relatives experience high levels of distress and express a need for DR care improvement. Health professionals are often influenced in their decision-making to intervene by external pressure or their need \'to do something\'. Both repositioning and explaining DR to relatives are seen as useful first-line non-pharmacological interventions by health professionals. The severity of DR does not improve when suctioning is performed before starting anticholinergics.
CONCLUSIONS: Variation in DR-related experiences and needs exists among relatives and health professionals. More research is needed into the effectiveness of non-pharmacological interventions for DR management and the most suitable measurement tools to objectify DR-related outcomes.
METHODS: Based on a PubMed literature search with the free-text term \"death rattle\", nine studies published in the last ten years were included.
UNASSIGNED: No significant correlation between DR intensity and patients\' respiratory distress could be found. Some relatives experience high levels of distress and express a need for DR care improvement. Health professionals are often influenced in their decision-making to intervene by external pressure or their need \'to do something\'. Both repositioning and explaining DR to relatives are seen as useful first-line non-pharmacological interventions by health professionals. The severity of DR does not improve when suctioning is performed before starting anticholinergics.
CONCLUSIONS: Variation in DR-related experiences and needs exists among relatives and health professionals. More research is needed into the effectiveness of non-pharmacological interventions for DR management and the most suitable measurement tools to objectify DR-related outcomes.
摘要：
目的：死亡嘎嘎声（DR）是临终患者的常见症状，由上呼吸道分泌物引起的.关于DR的经验因患者而异，亲戚,和卫生专业人员。然而,患者的证据，亲戚\',缺乏卫生专业人员对DR管理的需求，以改善他们的经验。此外,关于非药物干预对DR强度或DR相关窘迫的实际效果知之甚少.这篇叙述性综述旨在探讨(I)患者的经历和需求，亲戚,和健康专业人员关于DR的健康及其管理；和（II）关于DR管理中的非药物干预措施的研究。
方法：基于PubMed文献搜索，使用自由文本术语“死亡拨浪鼓”，纳入了过去十年发表的九项研究。
■DR强度与患者呼吸窘迫无显著相关性。一些亲属经历高度的痛苦，并表示需要改善DR护理。卫生专业人员在决策时往往受到外部压力或他们“做某事”的需要的影响。重新定位和向亲属解释DR都被卫生专业人员视为有用的一线非药物干预措施。在开始抗胆碱能药物之前进行抽吸时，DR的严重程度没有改善。
结论：亲属和卫生专业人员之间存在DR相关经历和需求的差异。需要更多研究非药物干预措施对DR管理的有效性以及最合适的测量工具来客观化DR相关结果。
方法：基于PubMed文献搜索，使用自由文本术语“死亡拨浪鼓”，纳入了过去十年发表的九项研究。
■DR强度与患者呼吸窘迫无显著相关性。一些亲属经历高度的痛苦，并表示需要改善DR护理。卫生专业人员在决策时往往受到外部压力或他们“做某事”的需要的影响。重新定位和向亲属解释DR都被卫生专业人员视为有用的一线非药物干预措施。在开始抗胆碱能药物之前进行抽吸时，DR的严重程度没有改善。
结论：亲属和卫生专业人员之间存在DR相关经历和需求的差异。需要更多研究非药物干预措施对DR管理的有效性以及最合适的测量工具来客观化DR相关结果。
