Management of dyspnea in patients with chronic obstructive pulmonary disease

摘要: A progressive and debilitating illness, chronic obstructive pulmonary disease (COPD) has major worldwide impact. In addition to the care for underlying causes of disease, COPD treatment involves palliative intervention address associated symptoms; in later stages when been maximally treated, symptom management assumes primacy as goal care. Dyspnea is most distressing experienced by patients. When dyspnea cannot be relieved traditional strategies (i.e., "refractory dyspnea"), shifts from prolonged survival minimized symptoms, improved function, enhanced quality life. Numerous pharmacologic non-pharmacologic interventions are available achieve these goals, but supporting evidence variable. This review summarizes options managing refractory patients, referring highlighting areas further investigation. Topics include oxygen, opioids, psychotropic drugs, inhaled frusemide, Heliox28, nutrition, psychosocial support, breathing techniques.