Clinical outcomes of opioid administration in acute and chronic heart failure: A meta-analysis

Pratama, Nando Reza; Anastasia, Elsha Stephanie; Wardhani, Nabila Putri; Budi, David Setyo; Susilo, Hendri; Alsagaff, Mochamad Yusuf; Wungu, Citrawati Dyah Kencono; Sutanto, Henry; Oceandy, Delvac

doi:10.1016/j.dsx.2022.102636

Cited by 1 publication

(1 citation statement)

References 52 publications

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“…Although the routine use of opioids for dyspnea is not recommended by the 2021 European Society of Cardiology guidelines, 21 a meta-analysis on their effects for chronic HF patients showed an advantage in exercise testing, but most studies included NYHA Class II/III patients and morphine use ranged from 10 to 20 mg/day. 22 Regarding palliative care for HF patients, there are differences in the background of opioid use in Japan and clinical results in other countries, so the initiation of opioid use requires thoughtful consideration of patient selection, opioid type, dosage, and assessment of efficacy and side effects.…”

Section: Discussionmentioning

confidence: 99%

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―

Nakamura,

Kai

et al. 2023

Circ Rep

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Background: For patients with advanced heart failure, palliative care, including opioids, is needed as a treatment for refractory dyspnea. However, little evidence has been reported on the efficacy and safety of opioids, and their use is not well established. Methods and Results: We have introduced a protocol for the use of opioids for dyspnea in patients with advanced heart failure admitted to Saitama Citizens Medical Center. Following this protocol, differences in clinical variables and outcome were investigated between patients in whom opioids were initiated intravenously or subcutaneously (i.v./s.c. group; n=13) and patients in whom they were initiated orally (oral group; n=18). In a comparison of baseline characteristics, significantly more patients in the oral group had a history of hospitalization for heart failure within the past year, and significantly more patients were treated with dobutamine and tolvaptan. After initiation of opioid treatment, both groups showed improvement in dyspnea; however, serial changes in vital signs were significantly greater in the i.v./s.c. group. The survival rate was significantly higher in the oral group (P<0.0001), with 33% of patients discharged alive. Conclusions: The clinical use of oral opioids using a single-center protocol is reported, suggesting that oral opioids may be practical and effective for dyspnea in patients with advanced heart failure.

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Section: Discussionmentioning

confidence: 99%

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―

Nakamura,

Kai

et al. 2023

Circ Rep

View full text Add to dashboard Cite

show abstract

Clinical outcomes of opioid administration in acute and chronic heart failure: A meta-analysis

Cited by 1 publication

References 52 publications

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―

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Clinical outcomes of opioid administration in acute and chronic heart failure: A meta-analysis

Cited by 1 publication

References 52 publications

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure ― A Single-Center Retrospective Study ―

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure ― A Single-Center Retrospective Study ―

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Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―

Clinical Use of Oral Opioid Therapy for Dyspnea in Patients With Advanced Heart Failure　― A Single-Center Retrospective Study ―