Refractory dyspnea Respiratory Abnormalities of breathing
Conditions
Interventions
240 participants will be recruited through the palliative care, oncology, pulmonary, cardiology, and general medicine departments at five sites in Australia, two sites in the USA, and two sites in the
Sponsors
Repatriation General Hospital (Australia)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Adult patients with intractable dyspnea and PaO2 >55 mmHg in the setting of terminal illness where the underlying cause has been maximally treated. A medical specialist must document that all identified reversible causes of the dyspnea have been treated. PaO2 measurement must be in the last month. 2. Dyspnea can be at rest or with minimal exertion, as measured by a score of =3 on the Medical Research Council categorical dyspnea exertion scale 3. On stable medications over the prior week except routine 'as needed' medications 4. Prognosis of at least 1 month in the opinion of the treating physician
Exclusion criteria
Exclusion criteria: 1. Meets international guidelines for long-term oxygen therapy with PaO2 56-59 mmHg i.e. symptomatic pulmonary hypertension with cor pulmonale 2. Hemoglobin 50 mmHg 4. Confusion with Folstein Mini-mental Status Exam (MMSE) <24/30 5. Current oxygen therapy or continuous oxygen therapy in previous week 6. Actively smoking 7. Active respiratory or cardiac event in the previous 7 days, not including upper respiratory tract infections. Illness must be resolved for at least 7 days prior to baseline evaluation, as judged by a doctor involved in the care of the patient. 8. Previous respiratory failure induced by oxygen 9. Unable to give informed consent or complete diary entries
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 0-10 Numeric rating scale for dyspnoea. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. McGill Quality of Life Questionnaire 2. Modified Medical Research Council Dyspnoea Scale 3. Dyspnoea Exertion Scale 4. Descriptors of dyspnoea 5. Verbal descriptor scales for nausea, drowsiness, nasal irritation, anxiety, patient preference 6. Costs of oxygen/air usage during and following participation | — |
Countries
Australia, United Kingdom, United States of America
Outcome results
None listed