Skip to main content
SpringerLink
Log in

Stratégies ventilatoires en situations palliatives

Ventilation strategies in palliative care

  • Mise au Point / Update
  • Published:
Réanimation

Résumé

Les soins palliatifs sont proposés aux patients souffrant de maladies à des stades avancés ou terminaux, afin de prévenir et de soulager leur souffrance et d’améliorer leur qualité de vie. La dyspnée est l’une des principales plaintes de ces patients. Pour soulager la dyspnée, différentes mesures sont proposées, dont l’oxygénothérapie et les médicaments morphiniques. En outre, la ventilation non invasive est parfois utilisée comme une stratégie palliative quand l’intubation est jugée inappropriée. Nous proposons une revue de la littérature sur la place de l’oxygénothérapie et de la ventilation non invasive palliatives dans des situations où l’intubation a été jugée inappropriée, dans les cardiopathies ou atteintes respiratoires en phase terminale, chez les patients âgés et les patients d’oncologie en fin de vie ou atteints de maladies neurodégénératives.

Abstract

Palliative care is proposed to patients with advanced and terminal illnesses in order to prevent and relieve suffering and improve their quality of life. Breathlessness is one of the main aspects of end-stage disease. To relieve dyspnea, different measures are proposed including oxygen and opioid drugs. Moreover, noninvasive ventilation is sometimes used as a palliative strategy when intubation is deemed inappropriate. We propose a review of literature concerning the place of palliative oxygen and non-invasive ventilation in different situations such as do-not-intubate orders, end-stage cardiac or respiratory failures, advanced age, end-of-life oncology patients or neurodegenerative diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Références

  1. Truog RD, Campbell ML, Curtis JR, et al (2008) Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med 36:953–63

    Article  PubMed  Google Scholar 

  2. Bailey FA, Burgio KL, Woodby LL, et al (2005) Improving processes of hospital care during the last hours of life. Arch Intern Med 165:1722–7

    Article  PubMed  Google Scholar 

  3. Mehta S, Hill NS (2001) Noninvasive ventilation. Am J Respir Crit Care Med 163:540–577

    Article  CAS  PubMed  Google Scholar 

  4. Wang S, Singh B, Tia L, et al (2013) Epidemiology of noninvasive mechanical ventilation in acute respiratory failure-a retro-spective population-based study. BMC Emergency Medicine 13:6

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Gay PC (2009) Complications of noninvasive ventilation in acute care. Respir Care 54:246–57

    PubMed  Google Scholar 

  6. Curtis JR, Cook DJ, Sinuff T, et al (2007) Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med 35:932–9

    Article  PubMed  Google Scholar 

  7. Sinuff T, Cook DJ, Keenan SP, et al (2008) Noninvasive ventilation for acute respiratory failure near the end of life. Crit Care Med 36:789–94

    Article  PubMed  Google Scholar 

  8. Azoulay E, Kouatchet A, Jaber S, et al (2013) Noninvasive mechanical ventilation in patients having declined tracheal intubation. Intensive Care Med 39:292–301

    Article  PubMed  Google Scholar 

  9. Azoulay E, Demoule A, Jaber S, et al (2011) Palliative noninvasive ventilation in patients with acute respiratory failure. Intensive Care Med 37:1250–7

    Article  PubMed  Google Scholar 

  10. Meduri GU, Fox RC, Abou-Shala N, et al (1994) Noninvasive mechanical ventilation via face mask in patients with acute respiratory failure who refused endotracheal intubation. Crit Care Med 22:1584–90

    Article  CAS  PubMed  Google Scholar 

  11. Levy M, Tanios MA, Nelson D, et al (2004) Outcomes of patients with do-notintubate orders treated with noninvasive ventilation. Crit Care Med 32:2002–7

    Article  PubMed  Google Scholar 

  12. Schettino G, Altobelli N, Kacmarek RM (2005) Noninvasive positive pressure ventilation reverses acute respiratory failure in select “do-not intubate” patients. Crit Care Med 33:1976–82

    Article  PubMed  Google Scholar 

  13. Duchateau FX, Beaune S, Ricard-Hibon A, et al (2010) Prehospital noninvasive ventilation can help in management of patients with limitations of life-sustaining treatments. Eur J Emerg Med 17:7–9

    Article  PubMed  Google Scholar 

  14. Benhamou D, Girault C, Faure C, et al (1992) Nasal mask ventilation in acute respiratory failure. Experience in elderly patients. Chest 102:912–7

    CAS  Google Scholar 

  15. Schortgen F, Follin A, Piccari L, et al (2012) Results of noninvasive ventilation in very old patients. Ann Intensive Care 2:5

    Article  PubMed Central  PubMed  Google Scholar 

  16. Fan C, Jin G, Sun C, et al (2014) Clinical characteristics, treatment patterns and survival outcome of hepatocellular carcinoma patients aged 70 years or older: a single-center retrospective study from China. Aging Clin Exp Res 26:123–30

    Article  PubMed  Google Scholar 

  17. Bosch-alcazar A (2014) Non-invasive ventilation improves comfort in pediatric palliative care patients. Enferm Intensiva pii: S1130-2399(14)00031-5

    Google Scholar 

  18. Buist AS, McBurnie MA, Vollmer WM et al (2007) International variation in the prevalence of COPD (the BOLD study): a population based prevalence study. Lancet 370:741–50

    Article  PubMed  Google Scholar 

  19. –Brown DW, Croft JB, Greenlund KJ et al (2010) Trends in hospitalization with COPD—United States, 1990–2005. COPD 7:59–62

    Article  PubMed  Google Scholar 

  20. White P, White S, Edmonds P, et al (2011) Palliative care or end-of-life care in advanced chronic obstructive pulmonary disease: a prospective community survey. Br J Gen Pract 61:e362–70

    Article  Google Scholar 

  21. Chu CM, Chan VL, Wong IW, et al (2004) Noninvasive ventilation in patients with acute hypercapnic exacerbation of chronic obstructive pulmonary disease who refused endotracheal intubation. Crit Care Med 32:372–7

    Article  PubMed  Google Scholar 

  22. Bülow HH, Thorsager B (2009) Non-invasive ventilation in do-not-intubate patients: five-year follow-up on a two-year prospective, consecutive cohort study. Acta Anaesthesiol Scand 53:1153–7

    Article  PubMed  Google Scholar 

  23. Corral-Gudino L, Jorge-Sanchez RJ, Garcia-Aparicio J, et al (2011) Use of noninvasive ventilation on internal wards for elderly patients with limitations to respiratory care: a cohort study. Eur J Clin Invest 41:59–69

    Article  PubMed  Google Scholar 

  24. Williams CM (2006) Dyspnoea. Cancer J 12:365–73

    Article  CAS  PubMed  Google Scholar 

  25. Cuomo A, Delmastro M, Ceriana P, et al (2004) Noninvasive mechanical ventilation as a palliative treatment of acute respiratory failure in patients with end-stage solid cancer. Palliat Med 18:602–10

    Article  PubMed  Google Scholar 

  26. Meert AP, Berghmans T, Hardy M, et al (2006) Noninvasive ventilation for cancer patients with life-support techniques limitation. Support Care Cancer 14:167–71

    Article  PubMed  Google Scholar 

  27. Nava S, Ferrer M, Esquinas A, et al (2014) Palliative use of noninvasive ventilation in end-of-life patients with solid tumours: a randomised feasibility trial. Lancet Oncol 14:219–27

    Article  Google Scholar 

  28. Azoulay E, Kouatchet A, Jaber S, et al (2013) Non-invasive ventilation for end-of-life oncology patients. Lancet Oncol 14:e200–1

    Article  Google Scholar 

  29. Kinali M, Manzur AY, Mercuri E, et al (2006) UK physicians’ attitudes and practices in long-term non-invasive ventilation of Duchenne muscular dystrophy. Pediatr Rehabil 9:351–64

    CAS  PubMed  Google Scholar 

  30. Bourke SC, Bullock RE, Williams TL, et al (2003) Noninvasive ventilation in ALS: indications and effect on quality of life. Neurology 61:171–7

    Article  CAS  PubMed  Google Scholar 

  31. Eng D (2006) Management guidelines for motor neurone disease patients on non-invasive ventilation at home. Palliat Med 20:69–79

    Article  PubMed  Google Scholar 

  32. American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Société de Réanimation de Langue Française (2001) International consensus conferences in intensive care medicine: noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 163:283–91

    Article  Google Scholar 

  33. Evans TW (2001) International consensus conferences in intensive care medicine: non-invasive positive pressure ventilation in acute respiratory failure. Organised jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Societe de Reanimation de Langue Francaise, and approved by the ATS Board of Directors, December 200. Intensive Care Med 27:166–78

    Article  CAS  PubMed  Google Scholar 

  34. British Thoracic Society Standards of Care Committee (2002) Non-invasive ventilation in acute respiratory failure. Thorax 57:192–211

    Article  Google Scholar 

  35. Crippen DW, Whestine LM (2004) Noninvasive ventilation and palliative care: Unfolding the promise. Crit Care Med 32:881–2

    Article  PubMed  Google Scholar 

  36. Azad A, Franco M (2013) Non-invasive ventilation for end-of-life oncology patients. Lancet Oncol 14:e199–200

    Article  Google Scholar 

  37. Ehlenbach WJ, Curtis R (2008) Noninvasive ventilation for patients near the end of life: what do we know and what do we need to know? Crit Care Med 36:1003–5

    Article  PubMed  Google Scholar 

  38. L’Her E, Duquesne F, Girou E, et al (2004) Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients. Intensive Care Med 30:882–8

    Article  PubMed  Google Scholar 

  39. Wright AA, Keating NL, Balboni TA, et al (2011) Place of death: correlations with quality of life of patients with cancer and predictors of bereaved caregivers’ mental health. J Clin Oncol 28:4457–64

    Article  Google Scholar 

  40. Principi T, Pantanetti S, Catani F, et al (2004) Noninvasive continuous positive airway pressure delivered by helmet in hematological malignancy patients with hypoxemic acute respiratory failure. Intensive Care Med 30:147–50

    Article  PubMed  Google Scholar 

  41. American Thoracic Society (1999) Dyspnea. Mechanisms, assessment, and management: a consensus statement. Am J Respir Crit Care Med 159:321–40

    Article  Google Scholar 

  42. Lynn J, Teno JM, Phillips RS, et al (1997) Perceptions by family members of the dying experience of older and seriously ill patients. SUPPORT Investigators. Ann Intern Med 126:97–106

    Article  CAS  PubMed  Google Scholar 

  43. Tanaka K, Akechi T, Okuyama T, et al (2002) Prevalence and screening of dyspnea interfering with daily life activities in ambulatory patients with advanced lung cancer. J Pain Symptom Manage 23:484–9

    Article  PubMed  Google Scholar 

  44. Abernethy AP, Uronis HE, Wheeler JL, Currow DC (2008) Pharmacological management of breathlessness in advanced disease. Prog Pailliat Care 16:15–20

    Article  Google Scholar 

  45. Uronis HE, Currow DC, Abernethy AP (2006) Palliative management of refractory dyspnea in COPD. Int J COPD 1:289–304

    Article  Google Scholar 

  46. Abernethy AP, Currow DC, Frith P, et al (2003) Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnoea. BMJ 327:523–8

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  47. Booth S, Anderson H, Swannick M, et al (2004) The use of oxygen in the palliation of breathlessness. A report of the expert working group of the Scientific Committee of the Association of Palliative Medicine Respir Med 98:66–77

    Article  Google Scholar 

  48. Abernethy AP, Currow DC, Frith P, Fazekas B (2005) Prescribing palliative oxygen: a clinician survey of expected benefit and patterns of use. Palliat Med 19:168–70

    PubMed  Google Scholar 

  49. Uronis HE, Currow DC, McCrory DC, et al (2008) Oxygen for relief of dyspnoea in mildly — or nonhypoxaemic patients with cancer: a systematic review and meta-analysis. Brit J Cancer 98:294–9

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  50. Uronis HE, Abernethy AP (2008) Oxygen for relief of dyspnea: What is the evidence? Cur Opinion Palliat Support Care 2:89–94

    Article  Google Scholar 

  51. Clemens KE, Quednau I, Klaschik E (2009) Use of oxygen and opioids in the palliation of dyspnea in hypoxic and non-hypoxic palliative care patients: a prospective study. Support Care Cancer 17:367–77

    Article  PubMed  Google Scholar 

  52. Abernethy AP, McDonald CF, Frith PA, et al (2010) Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet 376:784–93

    Article  PubMed Central  PubMed  Google Scholar 

  53. Frat JP, Goudet V, Girault C (2013) High flow, humidifiedreheated oxygen therapy: a new oxygenation technique for adults. Rev Mal Respir 30:627–43

    Article  PubMed  Google Scholar 

  54. Hui D, Morgado M, Chisholm G, et al (2013) High-flow oxygen and bilevel positive airway pressure for persistent dyspnea in patients with advanced cancer: a phase II randomized trial. J Pain Symptom Manage 46:463–73

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service de réanimation médicale, APHP, hôpital Saint Louis, F-75010, Paris, France

    M. Venot & É. Azoulay

  2. Service de réanimation médicale, CHU d’Angers, F-49000, Angers, France

    A. Kouatchet

  3. Réanimation DAR B, CHU Saint Éloi, Montpellier, INSERM U104, Montpellier, France

    S. Jaber

  4. Service de pneumologie et réanimation médicale, APHP, groupe hospitalier Pitié-Salpêtrière, F-75013, Paris, France

    A. Demoule

  5. Faculté de médecine, Université Paris-Diderot, Sorbonne Paris-Cité, F-75006, Paris, France

    A. Demoule & É. Azoulay

Authors
  1. M. Venot
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Kouatchet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Jaber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Demoule
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. É. Azoulay
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Venot.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Venot, M., Kouatchet, A., Jaber, S. et al. Stratégies ventilatoires en situations palliatives. Réanimation 24, 56–62 (2015). https://doi.org/10.1007/s13546-015-1023-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13546-015-1023-4

Mots clés

Keywords

Search

Navigation