Palliation of breathlessness

Abstract

Breathlessness is common in advanced progressive disease and is difficult to manage. Assessment is vital; the past medical history may be particularly relevant to the current experience of breathlessness. When managing specific causes of breathlessness, it is important to consider the ethical implications of the treatment. Non-pharmacological and pharmacological approaches to managing breathlessness are equally important; the latter will dominate at the end of life. Oxygen may be useful in patients with chronic obstructive pulmonary disease and cancer but alternatives should be considered. Opioids are important in symptomatic management of breathlessness; there is no evidence that they cause significant respiratory depression or hypercapnia if used sensibly.