Dyspnea review for the palliative care professional: treatment goals and therapeutic options.

Published

Journal Article (Review)

Although dyspnea is frequently encountered in the palliative care setting, its optimal management remains uncertain. Clinical approaches begin with accurate assessment, as delineated in part one of this two-part series. Comprehensive dyspnea assessment, which encompasses the physical, emotional, social, and spiritual aspects of this complex symptom, guide the clinician in choosing therapeutic approaches herein presented as part two. Global management of dyspnea is appropriate both as complementary to disease-targeted treatments that target the underlying etiology, and as the sole focus when the symptom has become intractable, disease is maximally treated, and goals of care shift to comfort and quality of life. In this setting, current evidence supports the use of oral or parenteral opioids as the mainstay of dyspnea management, and of inhaled furosemide and anxiolytics as adjuncts. Nonpharmacologic interventions such as acupuncture and pulmonary rehabilitation have potential effectiveness, although further research is needed, and use of a simple fan warrants consideration given its potential benefit and minimal burden and cost.

Full Text

Duke Authors

Cited Authors

  • Kamal, AH; Maguire, JM; Wheeler, JL; Currow, DC; Abernethy, AP

Published Date

  • January 2012

Published In

Volume / Issue

  • 15 / 1

Start / End Page

  • 106 - 114

PubMed ID

  • 22268406

Pubmed Central ID

  • 22268406

Electronic International Standard Serial Number (EISSN)

  • 1557-7740

International Standard Serial Number (ISSN)

  • 1557-7740

Digital Object Identifier (DOI)

  • 10.1089/jpm.2011.0110

Language

  • eng