Nonpharmacological management of dyspnea.
OBJECTIVE
Dyspnea is a common symptom experienced by patients suffering from life-limiting illnesses. This review aims to summarize the nonpharmacological therapies that exist to treat this complex symptom.


RESULTS
There is a wide array of nonpharmacological therapies to target the symptom of dyspnea by either changing physiologic factors or modifying the subsequent emotional response associated with the experience. Current research has been geared primarily toward patients with chronic obstructive pulmonary disease. Research related to other life-limiting illnesses and mind-body approach is starting to emerge. Invasive or noninvasive ventilation can be considered for some progressive illnesses when the symptom is refractory to other therapies.


CONCLUSIONS
Nonpharmacological therapies to treat the symptom of dyspnea are abundant. These therapies may be considered first-line as many have a low risk profile and allow for an integrative approach while avoiding polypharmacy. More research is needed to determine the degree of potential benefit we can anticipate from these therapies.
Buckholz
Gary T
GT
Institute for Palliative Medicine at San Diego Hospice, San Diego, California 92103, USA. gbuckholz@sdhospice.org
von Gunten
Charles F
CF
D000339:Affect; D001007:Anxiety / Q000209:etiology; D019090:Case Management; D003071:Cognition; D004417:Dyspnea / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D011603:Psychophysiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology