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

Not specified

Guidelines & Recommendations

  • Oxygen is not recommended for routine use. It can alleviate dyspnea in patients with hypoxia.
  • Opioids are identified as the only pharmacologic agents with sufficient evidence for effectiveness.
  • Benzodiazepines can be used in cases of insufficient response to opioids, either alone or in combination with opioids.
  • Little evidence for nonpharmacologic interventions exists.
  • In assessment, it is important to differentiate between continuous, episodic, breakthrough, or crisis breathlessness and determine exacerbating and relieving factors.
  • Treatment of reversible causes should be considered before starting symptomatic treatment.

Limitations

  • No specified systematic review
  • Written as mainly consensus-based

Nursing Implications

Provides very basic recommendations for dyspnea management in patients with advanced disease.