Kloke, M., Cherny, N., & ESMO Guidelines Committee. (2015). Treatment of dyspnoea in advanced cancer patients: ESMO Clinical Practice Guidelines. Annals of Oncology, 26(Suppl. 5), v169–v173.
DOI Link
Purpose & Patient Population
PURPOSE: To provide recommendations for the management of dyspnea in patients with advanced cancer
TYPES OF PATIENTS ADDRESSED: Advanced cancer
Type of Resource/Evidence-Based Process
RESOURCE TYPE: Consensus-based guideline
PROCESS OF DEVELOPMENT: Relevant literature was selected by the authors; not based on a systematic review
Phase of Care and Clinical Applications
PHASE OF CARE: End of life/palliative care
APPLICATIONS: Palliative care
Results Provided in the Reference
Guidelines & Recommendations
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Oxygen is not recommended for routine use. It can alleviate dyspnea in patients with hypoxia.
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Opioids are identified as the only pharmacologic agents with sufficient evidence for effectiveness.
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Benzodiazepines can be used in cases of insufficient response to opioids, either alone or in combination with opioids.
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Little evidence for nonpharmacologic interventions exists.
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In assessment, it is important to differentiate between continuous, episodic, breakthrough, or crisis breathlessness and determine exacerbating and relieving factors.
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Treatment of reversible causes should be considered before starting symptomatic treatment.
Limitations
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No specified systematic review
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Written as mainly consensus-based
Nursing Implications
Provides very basic recommendations for dyspnea management in patients with advanced disease.