[Supportive Therapie und Palliative Konzepte bei Dyspnoe].

Abstract

Introduction: Palliative care aims to treat patients who symptomatically are affected by an advanced, incurable disease. Dyspnoea is one of the most common symptoms in various diseases, not only the oncological ones. The treatment of these symptoms requires consideration from different points of view. In palliative care, the bio-psycho-socio-spiritual and cultural model is often applied. Here, different dimensions of the disease are considered, which are especially involved in the case of dyspnoea. The physiology of dyspnoea is very complex and is influenced by various neuronal as well as pulmonary anatomical structures. Various non-pharmacological as well as pharmacological treatment approaches can lead to a decrease in dyspnoea. In particular, active physiotherapy and assistive devices optimise the symptoms. From the pharmacological side, mainly opioids but also benzodiazepines, oxygen and Butylscopolamin are used. In the case of very advanced disease, the use of deep continuous sedation to relieve symptoms may be justified if the symptoms are refractory to therapy. Successful treatment of dyspnoea leads to a substantial improvement in the quality of life of palliative care patients.