Modalités pratiques d'une sédation en phase terminale ou en fin de vie en pédiatrie : prise de décision, mise en œuvre et surveillance

No work about the decision-making and implementation of sedation in final phase or at the end of the life in the child resting on a literature review and/or the opinion of a group of experts was recently published. This review of the literature with confrontation of experts' opinion aims to propose methods of decision-making, implementation and monitoring of sedation in this context. Decision-making must be anticipated, collegial, shared with the child like his family and nursing team. The implementation suggested initially specifies the way of administration, the drugs usable, the methods of induction by a titration and monitoring of sedation. The whole of the recommendations suggested fall under a prospect called clinical ethical step. They all benefit from a strong agreement of the experts' group having realized this work. Ethical questions raised by the practice of sedation, in this context, are tackled. This work proves the necessity of research and the necessity to validate clinical practice in this field. May be it will be interesting to share experience with colleagues all over the world to improve our practice and our reflexion in this field of medicine.