Clemens, K.E., & Klaschik, E. (2008). Effect of hydromorphone on ventilation in palliative care patients with dyspnea. Supportive Care in Cancer, 16(1), 93-99.doi: 10.1007/s00520-007-0310-3
The objective of this study was to assess the safety and effectiveness of hydromorphone for the improvement of ventilation and intensity of dyspnea in palliative care patients.
Baseline intensity of dyspnea was recorded at rest and during exertion during a light physical activity. Baseline data, including arterial pressure of carbon dioxide (tcPaCO2), peripheral oxygen saturation (SaO2), and pulse frequency (PF) were measured continuously via a noninvasive calibrated digital sensor (i.e., the SenTec Digital Monitor) attached to the patients’ earlobe. They then were initiated on orally administered hydromorphone every four hours and titrated to at least 50% dyspnea reduction. Rescue doses of one-sixth of the calculated daily dose were made available for relief of breakthrough dyspnea.
The single-site study was conducted in an inpatient setting on a palliative care unit at the Center for Palliative Medicine in Germany.
Patients were undergoing end-of-life and palliative care.
The study was a prospective, nonrandomized trial.
Use of oral hydromorphone potentially could reduce dyspnea with minimal risk of respiratory depression to patients with advanced or terminal cancer.
Use of hydromorphone in the palliative care setting may serve as an effective treatment alternative for patients with renal impairment or intolerance to morphine in the management of dyspnea and work of ventilation. Hydromorphone may reduce dyspnea even in patients who already are receiving opiates for other symptoms.