Palliative management of breathlessness.

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Australian Journal of General Practice Pub Date : 2025-08-01 DOI:10.31128/AJGP-06-24-7306

Claire Stokes, Phillip Good, Jones Chen, Taylan Gurgenci

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引用次数: 0

Abstract

Background: Breathlessness is a subjective experience of breathing discomfort and is one of the most common symptoms in patients receiving palliative care.

Objective: This paper reviews the palliative management of breathlessness.

Discussion: Current management guidelines for the palliative management of breathlessness recommend treatment of reversible causes followed by non-pharmacological interventions such as breathing exercises, use of mobility aids, fans and focused psychological strategies. For those not responding, opioids might be considered with a reasonable starting dose being immediate release oral morphine 1-2.5 mg hourly as required (prn). Benzodiazepines, such as lorazepam 0.5 mg every 3-4 hours prn, might be used for the treatment of breathlessness-associated anxiety but do not a have role in the management of breathlessness per se. Systemic corticosteroids have limited evidence but can be considered in some cases. The use of home oxygen in patients who are non‑hypoxic lacks evidence but might be used after consideration of patient preferences. Patients might benefit from a breathlessness management plan.

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呼吸困难的姑息治疗。

背景：呼吸困难是呼吸不适的主观体验，是接受姑息治疗的患者最常见的症状之一。目的：综述呼吸困难的姑息治疗方法。讨论：目前关于呼吸困难姑息治疗的管理指南建议对可逆性原因进行治疗，然后进行非药物干预，如呼吸练习、使用活动辅助工具、风扇和重点心理策略。对于那些没有反应的患者，可以考虑使用阿片类药物，合理的起始剂量是根据需要立即释放口服吗啡1-2.5 mg每小时（prn）。苯二氮卓类药物，如劳拉西泮每3-4小时0.5毫克，可用于治疗呼吸困难相关的焦虑，但在呼吸困难本身的管理中没有作用。全身性皮质类固醇的证据有限，但在某些情况下可以考虑使用。在非缺氧患者中使用家庭供氧缺乏证据，但可以在考虑患者偏好后使用。患者可能会从呼吸困难管理计划中受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australian Journal of General Practice Medicine-Family Practice

CiteScore

2.80

自引率

4.50%

发文量

284

期刊介绍： The Australian Journal of General Practice (AJGP) aims to provide relevant, evidence-based, clearly articulated information to Australian general practitioners (GPs) to assist them in providing the highest quality patient care, applicable to the varied geographic and social contexts in which GPs work and to all GP roles as clinician, researcher, educator, practice team member and opinion leader. All articles are subject to peer review before they are accepted for publication.