|Description||Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The
duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a
prolonged period of gasping lasting minutes or even hours. Gasping respiration is very abnormal, easy
to recognise and distinguish from other respiratory patterns and, in the dying patient who has elected
to not be resuscitated, will always result in terminal apnoea.
Gasping respiration is also referred to as agonal respiration and the name is appropriate because the
gasping breaths appear uncomfortable and raise concern that the patient is suffering and in agony.
Enough uncertainty exists about the influence of gasping respiration on patient wellbeing, that it is
appropriate to assume that the gasping breaths are burdensome to patients. Therefore, gasping respiration
at the end of life should be treated.
We propose that there is an ethical basis, in rare circumstances, for the use of neuromuscular blockade
to suppress prolonged episodes of agonal respiration in the well-sedated patient in order to allow a
peaceful and comfortable death. Originally published Journal of Medical Ethics, Vol. 28, No. 3, June 2002||en_US