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Management of refractory breathlessness in patients with advanced cancer

Behandlung der therapierefraktären Atemnot bei Patienten mit fortgeschrittenen Tumorerkrankungen

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Zusammenfassung

Atemnot ist ein häufiges und belastendes Symptom bei Patienten mit fortgeschrittener Tumorerkrankung. Die Behandlung umfasst nicht-pharmakologische und pharmakologische Maßnahmen, die am besten miteinander kombiniert werden. Es gibt einige Evidenz überwiegend von Studien bei COPD-Patienten für den Einsatz von Rollatoren, neuro-elektrischer Nervenstimulation, Handventilatoren und Atemnotambulanzen. Opioide sind die Medikamente der Wahl bei der Behandlung der Atemnot. Für den routinemäßigen Einsatz von Benzodiazepinen, anderen Anxiolytika, Antidepressiva, Phenothiazinen, inhaliertem Furosemid und Sauerstoff gibt es derzeit keine ausreichende Evidenz.

Summary

Breathlessness is a common and distressing symptom in advanced cancer. Management comprises non-pharmacological and pharmacological interventions, which are best combined. There is some evidence mainly derived from COPD studies for walking aids, neuro-muscular electrical stimulation, fan and breathlessness services. Opioids are the drugs of choice for pharmacological management of breathlessness. There is currently not enough evidence to support the routine use of benzodiazepines, other anxiolytics, antidepressants, phenothiazines, inhaled furosemide and oxygen.

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Authors and Affiliations

  1. Department of Palliative Care, Policy and Rehabilitation, King's College London, London, UK

    Steffen T. Simon & Claudia Bausewein

  2. Institute of Palliative Care (ipac), Oldenburg, Germany

    Steffen T. Simon & Claudia Bausewein

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  1. Steffen T. Simon
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  2. Claudia Bausewein
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Correspondence to Claudia Bausewein.

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Simon, S., Bausewein, C. Management of refractory breathlessness in patients with advanced cancer. Wien Med Wochenschr 159, 591–598 (2009). https://doi.org/10.1007/s10354-009-0728-y

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  • DOI: https://doi.org/10.1007/s10354-009-0728-y

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