An approach to dyspnea in advanced disease.
BACKGROUND
To describe an approach to assessment and treatment of dyspnea.


METHODS
New level I evidence can guide management of dyspnea in advanced illness. Assessment and use of adjuvant medications and oxygen relies on level II and III evidence.


RESULTS
Opioids are first-line therapy for managing dyspnea in advanced illness. They are safe and effective in reducing shortness of breath. Neuroleptics are useful adjuvant medications. Evidence does not support use of oxygen for every patient experiencing dyspnea; it should be tried for patients who do not benefit from first-line medications and nonmedicinal therapies.


CONCLUSIONS
Opioids relieve dyspnea and are indicated as first-line treatment for dyspnea arising from advanced disease of any cause.
Gallagher
Romayne
R
Department of Family Practice, University of British Columbia, Vancouver. romayne@interchange.ubc.ca
D014150:Antipsychotic Agents / Q000627:therapeutic use*; D004417:Dyspnea / Q000175:diagnosis* / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D009294:Narcotics / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013727:Terminal Care
D014150:Antipsychotic Agents; D009294:Narcotics