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Dyspnea in palliative care

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Updated 2024 ERS guidelines for symptomatic management in serious respiratory diseases.

Guidelines

Key sources

The following summarized guidelines for the evaluation and management of dyspnea in palliative care are prepared by our editorial team based on guidelines from the European Respiratory Society (ERS 2024,2017), the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2024), the American Society of Clinical Oncology (ASCO 2021), the European Society of Medical Oncology (ESMO 2021), the American Thoracic Society ...
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Diagnostic investigations

Clinical assessment: as per ERS 2024 guidelines, consider using needs assessment tools as part of a comprehensive evaluation, but do not replace patient-centered care and shared decision-making.
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Respiratory support

Breathing techniques: as per ERS 2024 guidelines, consider offering breathing techniques to reduce symptoms in patients with serious respiratory illness.
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  • Airflow interventions

  • Supplemental oxygen

  • Noninvasive ventilation

Medical management

General principles: as per ERS 2024 guidelines, consider incorporating multicomponent services to reduce symptoms in patients with serious respiratory illness.
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  • Management of underlying conditions

  • Opioids

  • Benzodiazepines

  • Antidepressants

  • Corticosteroids

  • Bronchodilators

  • Sedation

  • Therapies with no evidence for benefit

Nonpharmacologic interventions

Exercise: as per ERS 2024 guidelines, consider offering graded exercise therapy to reduce fatigue in patients with serious respiratory illness.
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  • Walking aids

  • Nutritional support

  • Alternative and complementary therapies

Therapeutic procedures

Neuromuscular electrical stimulation: as per GOLD 2024 guidelines, consider offering neuromuscular electrical stimulation in patients with advanced COPD.
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