Obravnava težkega dihanja pri bolnikih v zadnjih dneh življenja Alleviating symptomatic heavy breathing in terminal patients

Povzetek

Občutek težkega dihanja (dispneja) je pogost simptom v zadnjih dneh življenja. Bolnik je zaradi dispneje zelo prizadet in velikokrat prestrašen. Ključno je, da ob takem bolniku ukrepamo hitro in pravilno. Pogoste napake so pretirana uporaba nepotrebnih diagnostičnih metod in neustrezno lajšanje simptomov. V prispevku prikazujemo obravnavo bolnika z dispnejo v terminalni fazi bolezni, ko vzročno zdravljenje ni več mogoče in je v ospredju lajšanje težav. Definiciji dispneje sledijo patofiziološka razlaga in praktični nasveti za uporabo farmakoloških in nefarmakoloških ukrepov. Na koncu so opisani ukrepi pri terminalnem hropenju in akutni obsežni krvavitvi iz dihal.

Abstract (Eng)

Dyspnoea is a distressing symptom frequently present in patients with incurable diseases. The goal of treatment for patients in the terminal stage is symptom control. Unfortunately, optimal treatment of dyspnoea has not been achieved in all patients yet. Frequent mistakes include unnecessary diagnostic procedures and suboptimal symptom control. In this review, the definition of dyspnoea is presented, followed by etiologic and epidemiologic data and pharmacological and non-pharmacological measures for relief. At the end, two more symptoms are presented; terminal rattle and massive pulmonary haemorrhagia.