Management of dyspnea in patients with advanced lung or heart disease: practical guidance from the American college of chest physicians consensus statement.

摘要: INTRODUCTION Patients with advanced lung or heart disease are not generally being treated consistently and effectively for relief of dyspnea. OBJECTIVES The aim the paper was to review available literature provide consensus statements using Delphi method relevant topic condition. PATIENTS AND METHODS A panel experts American College Chest Physicians (ACCP) defined condition as "dyspnea that persists at rest minimal activity is distressful despite optimal therapy disease." After a review, developed 23 were assessed agreement/disagreement on 5-point Likert scale 2 rounds method. RESULTS For first round method, survey sent 15 expert members. Some modified if deemed appropriate. second 56 clinicians from 5 specialty NetWork steering committees ACCP. Agreement least 70% achieved 20 statements. CONCLUSIONS There that: patients should be asked about intensity distress their breathlessness; pursed-lips breathing, relaxation, oxygen those hypoxemia, noninvasive positive pressure ventilation, oral/parental opioids can dyspnea; therapies started understanding patient clinician will reassess whether specific treatments relieving dyspnea without causing adverse effects; it important communicate palliative end-of-life care.