Objective To identify the best therapy regime for dyspnea in an end-stage cancer patient.Method We searched The Cochrane Library (Issue 2, 2006), SUMsearch (1978 to 2006) and MEDLINE (1978 to 2006), and identified 4 systematic reviews and 28 randomised controlled trials. We critically assessed the quality of these studies. Result Evidence supported the use of breathing exercise, desensitisation, oral or parenteral opioids and antianxiety drugs to pall iate breathlessness. Patients with hypoxemia were found to benefit from oxygen therapy. Conclusions Physiotherapy, psychotherapy, oxygen therapy, opioids and antianxiety drugs can be considered in treating cancer patients with dyspnea.
ObjectiveTo evaluate the clinical value of three clinical methods for rating dyspnea in chronic obstructive pulmonary disease (COPD). MethodsSixty-six patients with stable COPD visiting the respiratory department between January 2012 and December 2014 were recruited in the study. Quality of life was assessed by the Chinese version SF-36,and dyspnea was assessed by the medical research council scale (MRC),oxygen-cost diagram (OCD) and baseline dyspnea index (BDI),respectively. All patients underwent pulmonary function test. ResultsDyspnea scores from all three methods were significantly correlated (r value ranged from -0.855 to 0.915),but they had no correlation with height,age or weight. Dyspnea scores obtained from the MRC,OCD and BDI correlated significantly with FVC,FEV1,RV/TLC and DLCO(r value ranged from 0.269 to -0.461),but not obviously correlated with FEV1/FVC. Three dyspnea scores were all significantly correlated with six components of the SF-36,except the role limitations due to emotional problems and mental healthy. The spirometic values were significantly correlated with two components of the SF-36,including physical functioning and role limitations due to emotional problem. Dyspnea had more closely correlation with the life quality than the spirometic values. ConclusionThree methods for rating dyspnea show good consistency with different physiological index.
Dyspnea is the most common symptom in patients with acute heart failure syndrome (AHFS), and relieving dyspnea is an important goal in clinical practice, clinical trials and new drug regulatory approval. However, in clinical and scientific research, there is still no consensus on how to evaluate dyspnea, and there is still a lack of unified measurement methods. This article introduces the pathophysiological mechanism of dyspnea in acute heart failure, the measuring time of dyspnea, the posture of patients during measurement, the measuring conditions, and the common measurement methods of dyspnea in clinical trials and their advantages and disadvantages, so as to provide references for the selection of measurement methods of dyspnea in clinical trials of acute heart failure.