Therapeutic target
Relief of dyspnea
Therapy recommendations
- Therapy for respiratory distress in nonpalliative patients depends on the underlying disease.
- Symptomatic therapy
- Oxygen administration; indications: Patients with hypoxia (SpO2 < 90%), dyspnea, or acute heart failure.
- Installation of intravenous access
- If necessary, immediate intubation; active search for causes of dyspnea that can be remedied immediately.
- Palliative patients (treatment not aimed at curing an existing underlying disease) with dyspnea:
- Education about the symptom of dyspnea, sedation/relaxation, breathing exercises or cooling of the face.
- Opioid analgesics
- Diazepam, lorazepam, midazolam (benzodiazepines).
- Levomepromazine, promethazine (Conventional (Classical) Antipsychotics (Neuroleptics))
- Administration of oxygen (starting at 2 l/min); contraindication (contraindication): oxygen should not be used to relieve respiratory distress in non-hypoxemic (“oxygen deficient”) patients with noncurable cancer.
- See also under “Other therapy.”
Further notes
- In the terminal phase (last phase of life), switch morphine administration to s.c., increase dose if necessary; switch to midazolam (benzodiazepine, with antianxiety, depressant, sleep-inducing, and anticonvulsant properties) if necessary.
