Management of Dyspnea in Patients With Far-Advanced Lung Disease

Luce, John M.; Luce, Judith

doi:10.1001/jama.285.10.1331

Cited by 65 publications

(10 citation statements)

References 47 publications

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“…In end-stage disease, one option may also be to reduce ventilatory demand by decreasing the central drive with opiates. These have been shown to decrease minute ventilation at rest and during submaximal exercise, thus reducing the sensation of breathing and its associated anxiety [133]. There is also speculation that opiates act directly on opioid receptors in the airways [134].…”

Section: Drug Therapymentioning

confidence: 99%

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Clini

Ambrosino²

2008

Eur Respir J

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Evidence-based guidelines for chronic obstructive pulmonary disease (COPD) have recently been developed.Nonpharmacological treatments have evolved rapidly as an essential part of COPD therapy. They are especially important as complementary interventions in severe or very severe disease, when there is loss in function, a reduction in quality of life and when psychological impairments further complicate the disease.The present article discusses the most used nonpharmacological treatments for severe COPD patients (rehabilitation, long-term oxygen therapy, surgery, noninvasive positive pressure ventilation and supportive nutrition) and their evidence-based usefulness in promoting strategies that relieve symptoms.All of these interventions are used during end-stage disease, to promote self-efficacy, relieve symptoms and prevent further deterioration. These therapeutic options support physicians and allied professionals in improving symptom management for their patients.

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Section: Drug Therapymentioning

confidence: 99%

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Clini

Ambrosino²

2008

Eur Respir J

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“…These can serve as valuable adjuncts to the expert analgesic and anxiolytic pharmacotherapy already required in this setting. In addition to paracentesis to mitigate abdominal discomfort, analogous use of thoracentesis for chest discomfort or dyspnea could be considered 11,26,27 . Further potential home‐based palliative or therapeutic uses include guidance of intravenous access 26,28 and assessment and incision of cutaneous abscesses.…”

Section: Discussionmentioning

confidence: 99%

Palliative Ultrasound for Home Care Hospice Patients

Mariani

Setla

2010

Academic Emergency Medicine

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The evolving relationship between emergency and palliative medicine is expected to benefit patients of each. Two collaborative care encounters involving home hospice patients are discussed. Portable bedside ultrasound was performed in the home to diagnose ascites and to guide palliative paracentesis. Specific interventions and outcomes are reported. The interface of emergency and palliative care and the use of paracentesis in cancer palliation are briefly reviewed. It is concluded that home-performed ultrasound and ultrasound-guided procedures are promising palliative modalities for care at the end of life.ACADEMIC EMERGENCY MEDICINE 2010; 17:293-296 ª

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“…Several of these articles have direct relevance to the clinical management of respiratory patients such as Mr LV. [31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] These articles have been updated with recent evidence as a book and published as Care at the close of life: Evidence and experience. 47 Its 42 chapters are rich with examples of words that clinicians can utilize.…”

Section: Our Recommendationsmentioning

confidence: 99%

Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin?

2012

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Pulmonary rehabilitation and palliative care are two important components of the integrated care of the patient with chronic respiratory disease such as chronic obstructive pulmonary disease (COPD). These two interventions are remarkably similar in many respects. Both utilize a multidisciplinary team that focuses on the specific needs of the individual patient. Care in both is goal defined and includes relief of symptoms and improvements in functional status and quality of life. Pulmonary rehabilitation is commonly given in a specific setting, such as a hospital-based outpatient setting, while palliative care is often hospital based, with its services extending into the home setting in the form of hospice. Components of pulmonary rehabilitation and palliative care should be administered as part of good medical care. Both pulmonary rehabilitation and palliative care are currently underutilized in the respiratory patient, and often provided relatively late in the patient's clinical course. The case provided illustrates the often-overwhelming symptom burden of advanced COPD and demonstrates opportunities for the application of these twin interventions.

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Management of Dyspnea in Patients With Far-Advanced Lung Disease

Cited by 65 publications

References 47 publications

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Nonpharmacological treatment and relief of symptoms in COPD: Table 1—

Palliative Ultrasound for Home Care Hospice Patients

Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin?

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