Tracheobronchial secretions in the dying patient

At a glance

• Noisy, rattling breathing in a patient in the last hours to days of life, from secretions they can't clear. It affects roughly a third to a half of dying patients (reported range 23 to 92%).
• It is a sign of imminent death: most patients die within a day or two of onset, though a few live longer.
• There is no good evidence that the noise distresses the patient, who is usually unconscious. It distresses families and staff, and explaining it is the main intervention.