Perspectives on care at the close of life. Management of dyspnea in patients with far-advanced lung disease: "once I lose it, it's kind of hard to catch it... ".
Dyspnea is a common problem among patients with interstitial fibrosis, lung cancer, cystic fibrosis, and chronic obstructive pulmonary disease. The slow but steady progression of such diseases, often punctuated by acute exacerbations or secondary illnesses, can lead to decision-making dilemmas among...
| Publicado en: | JAMA: Journal of the American Medical Association Vol. 285; no. 10; pp. 1331 - 1338 |
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| Autores principales: | , , , |
| Formato: | case study CEU tables/charts Journal Article |
| Publicado: |
American Medical Association
3/14/2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106968168&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106968168 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00987484 AMA jtl: JAMA: Journal of the American Medical Association issn: 00987484 maglogo: N pubinfo: dt: 3/14/2001 vid: 285 iid: 10 pid: 30 pub: American Medical Association place: Chicago, Illinois artinfo: ui: 106968168 106968168 NLM11255389 2002134621 10.1001/jama.285.10.1331 NLM11255389 106968168 ppf: 1331 ppct: 7 formats: tig: atl: Perspectives on care at the close of life. Management of dyspnea in patients with far-advanced lung disease: "once I lose it, it's kind of hard to catch it... ". aug: au: Luce JM Luce JA Luce, J M Luce, J A affil: Division of Pulmonary and Critical Care Medicine, San Francisco General Hospital, 1001 Potrero Ave, Room 5K1, San Francisco, CA 94110, USA sug: subj: Terminal Care Dyspnea Prevention and Control Dyspnea Therapy Terminally Ill Patients Home Oxygen Therapy Emphysema Complications Lung Neoplasms Complications Lung Diseases, Obstructive Prevention and Control Analgesics Therapeutic Use Palliative Care Education, Continuing (Credit) Aged Female Aged: 65+ years Female ab: Dyspnea is a common problem among patients with interstitial fibrosis, lung cancer, cystic fibrosis, and chronic obstructive pulmonary disease. The slow but steady progression of such diseases, often punctuated by acute exacerbations or secondary illnesses, can lead to decision-making dilemmas among patients and their caregivers, such as when to accept mechanical ventilation, when to forgoe aggressive therapies, and when to make formal end-of-life care plans. Two cases, a 74-year-old woman with dyspnea secondary to emphysema and a 65-year-old woman with recurrent lung cancer and severe exertional fatigue and dyspnea, illustrate how dyspneic patients approaching the end of life can be evaluated and treated. Four management strategies for dyspnea are discussed: reducing ventilatory impedance, reducing ventilatory demand, improving respiratory muscle function, and altering central perception. Physicians should encourage end-stage lung disease patients and their families to discuss issues such as hospitalization and mechanical ventilation, to prepare advance directives, and to participate in a plan to manage their dyspnea. pubtype: Academic Journal doctype: case study CEU tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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