Wiener medizinische Wochenschrift
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Wien Med Wochenschr · Dec 2009
Case Reports[Invasive and non-invasive ventilation in conflict with best palliative care in severe COPD].
This example of an 80-year-old patient with severe lung disease and respiratory failure demonstrates the difficult relationship between the patient's needs, physical symptoms, and social problems. This man decides after a prolonged and difficult in-patient treatment actively for home ventilation rather than die of respiratory failure. ⋯ It requires professional communication and support to gain the acceptance of family and caregivers for home ventilation. A survey of existing data on end of life decision-making in end-stage lung disease is given.
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Wien Med Wochenschr · Dec 2009
ReviewManagement of refractory breathlessness in patients with advanced cancer.
Breathlessness is a common and distressing symptom in advanced cancer. Management comprises non-pharmacological and pharmacological interventions, which are best combined. ⋯ Opioids are the drugs of choice for pharmacological management of breathlessness. There is currently not enough evidence to support the routine use of benzodiazepines, other anxiolytics, antidepressants, phenothiazines, inhaled furosemide and oxygen.