Palliation of Dyspnea: Moving Beyond Oxygen (SA525)

Abstract

1.Recognize that hypoxia may not be accompanied by dyspnea and that dyspnea often is not due to hypoxia.2.Summarize the concept of neuromechanical dissociation (or mismatch).3.Use these concepts to move beyond only using O2 for palliation of dyspnea. Dyspnea is a distressing but frequently observed symptom in hospice patients, especially those with diagnoses of end stage pulmonary disease, end stage heart disease, and cancer. The presence of oxygen to treat dyspnea in these settings is almost ubiquitous. Using lessons from classic high altitude medicine, diving medicine, and pulmonary medicine physiology, this session will make the case that oxygen usage should not be the first or only modality of therapy used to palliate the symptom of dyspnea. This session will describe the model of neuromechanical dissociation (or neuromechanical mismatch) to help better understand the symptom of dyspnea. This model serves as the framework to extend the discussion of treatments of dyspnea beyond just using oxygen.