Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Sep 2007
Comparative Study[Symptomatic treatment of dyspnoea in patients receiving palliative care: nasal delivery of oxygen compared with opioid administration].
Dyspnoea frequently occurs in patients with advanced tumor disease receiving palliative care (prevalence > 50). Aim of the study was to assess, in dyspneic patients in palliative care, the efficacy of opioids in treating their dyspnoea and to determine whether or not nasal administration of oxygen previous to opioid administration would decrease the severity of dyspnoea. ⋯ During nasal oxygen administration the severity of dyspnoea, as measured by use of NRS had not decreased, whereas it had significantly decreased after the first opioid administration.
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A 69-year-old female patient was admitted to a hospital for severe dyspnoea. It was conspicuous that shortness of breath and cyanosis only occurred in upright and completely disappeared in the supine position. This finding was objectified by pulse oximetry which demonstrated a decrease of arterial oyxgen saturation from 96 % in the supine to 86 % in the upright position. ⋯ Platypnoe-othodeoxia syndrome is a very rare syndrome but it can be substantiated by pathognomonic case history, clinical examination and simple machine-aided examinations. With a causative PFO a causal and save therapy is available.