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

Arif Kamal, Jennifer Maguire, J Wheeler, David Currow, Amy Abernethy

    Research output: Contribution to journalArticle

    49 Citations (Scopus)

    Abstract

    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.

    Original languageEnglish
    Pages (from-to)106-114
    Number of pages9
    JournalJournal of Palliative Medicine
    Volume15
    Issue number11
    DOIs
    Publication statusPublished - 2012

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