Clinical management of dyspnoea

Validation of a Swedish Version of the Cancer Dyspnea Scale

“…There are three components in the patophysiology of dyspnea: the work of breathing component, the chemical component and the neuromechanical component (Thomas & von Gunten 2002). Breathing is controlled by the respiratory centre in the brainstem (Ripamonti & Bruera 1997), which receives information from receptors in the mechanoreceptors in the lung, airways and chest wall and from chemoreceptors in the brain or periphery.…”

“…Breathing is controlled by the respiratory centre in the brainstem (Ripamonti & Bruera 1997), which receives information from receptors in the mechanoreceptors in the lung, airways and chest wall and from chemoreceptors in the brain or periphery. The work of breathing component in dyspnea includes the increased effort required for breathing against resistance or breathing with weakened muscles (Manning & Schwartzstein 1995;Thomas & von Gunten 2002;LeGrand 2002). The chemical component especially concerns the medullary chemoreceptors that are sensitive to hypercapnia (Manning & Schwartzstein 1995).…”

“…The chemical component especially concerns the medullary chemoreceptors that are sensitive to hypercapnia (Manning & Schwartzstein 1995). The neuromechanical dissociation refers to when there is a mismatch between what the brain desires for respiration and the sensory feedback it receives (Thomas & von Gunten 2002). Upper air-way and facial receptors may modify the sensation of dyspnea (Manning & Schwartzstein 1995).…”

Application of palliative ventilation: potential and clinical evidence in palliative care

“…It may be caused by cancer itself, and preexisting or concomitant co-morbid conditions [2]. Dyspnea is associated with fatigue, anxiety, decreased function and quality of life and increased mortality [3,4], and significant suffering both for patients and caregivers.…”

Effect of the Sedative Combination of Ketamine, Morphine and Midazolam on the Quality-of-Life in the Final Days of Terminally Ill Cancer Patients

“…Other studies demonstrated that adding midazolam to morphine helped in alleviating severe dyspnea perception [12]. Although opiates have anti-anxiety effects initially, midazolam may contribute to this effect as tolerance to opiates develops during treatment [13].…”