Response to “Hyoscine butylbromide for the management of death rattle: sooner rather than later”

We have read with interest the paper by Mercadante et al [1] and congratulate the authors on completing this work in a group notoriously hard to study. While the outcomes of the study at face value support the regular use of anticholinergics to reduce the phenomena of noisy secretions, we believe the routine use of medications is not supported within the available evidence.

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