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Palliative Therapie der Atemnot bei fortgeschrittenen Erkrankungen

Management of refractory breathlessness in patients with advanced disease

  • Schwerpunkt: Palliativmedizin
  • Published:
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Zusammenfassung

Hintergrund

Atemnot ist ein häufiges und belastendes Symptom bei fortgeschrittenen Erkrankungen. Sie beeinträchtigt die Lebensqualität der Patienten und ihrer Angehörigen erheblich.

Ziel der Arbeit

Auf Basis der vorhandenen Evidenz werden die nichtmedikamentösen und medikamentösen Behandlungsoptionen für Atemnot zusammengefasst.

Material und Methoden

Es wurden Primärstudien, Übersichtsarbeiten und Leitlinien zu den genannten Symptomen und deren Behandlung ausgewertet.

Ergebnisse

Wichtig für die Behandlung der Atemnot sind zunächst das Erkennen und die Evaluation. Zur Therapie stehen nichtmedikamentöse und medikamentöse Maßnahmen zur Verfügung, die in der Regel miteinander kombiniert werden sollten. Allgemeine Informationen, ein Plan zum Umgang mit Atemnot, der Einsatz eines Handventilators, körperliche Aktivität und Rollatoren gehören zu den nichtmedikamentösen Maßnahmen. Opioide sind Medikamente der ersten Wahl für eine therapierefraktäre Atemnot. In Bezug auf Benzodiazepine und andere Medikamente ist die Evidenz nur gering.

Schlussfolgerung

Für die Behandlung der Atemnot gibt es eine Reihe von Therapieoptionen, die dem Patienten besonders im nichtmedikamentösen Bereich helfen, besser mit der Atemnot zurechtzukommen.

Abstract

Background

Breathlessness is a frequent and distressing symptom in advanced disease. It can have a significant impact on the quality of life of both patients and relatives.

Objectives

A summary of nonpharmacological and pharmacological measures for breathlessness based on existing evidence is provided.

Materials and methods

Analysis of primary studies, reviews and guidelines for the named symptoms and their management were analyzed.

Results

Recognition and assessment are essential for the management of breathlessness. Management includes various nonpharmacological and pharmacological measures, which should be combined for best results. Nonpharmacological strategies comprise general information, management plan, hand-held fan, physical activity, and rollators. Opioids are the drugs of choice for intractable breathlessness. The evidence base for benzodiazepines and other drugs is rather weak.

Conclusion

A number of treatment options, especially in the nonpharmacological area, help the patients to better cope with their breathlessness.

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Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Palliativmedizin, Klinikum der Universität München, Marchioninistr. 15, 81377, München, Deutschland

    C. Bausewein PhD, M.Sc.

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  1. C. Bausewein PhD, M.Sc.
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Correspondence to C. Bausewein PhD, M.Sc..

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Interessenkonflikt

C. Bausewein erhält Unterstützung durch das Bundesministerium für Bildung und Forschung (BMBF) zur Testung der Effektivität einer Atemnotambulanz (Förderkennzeichen 01GY1331) und zur Erstellung eines Cochrane-Reviews (Förderkennzeichen 01KG1502). Sie erhielt ein Vortragshonorar von Bayer Healthcare.

Dieser Beitrag beinhaltet keine von der Autorin durchgeführten Studien an Menschen oder Tieren.

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M. Hallek, Köln

H. Lehnert, Lübeck

C. Sieber, Nürnberg

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Bausewein, C. Palliative Therapie der Atemnot bei fortgeschrittenen Erkrankungen. Internist 57, 978–982 (2016). https://doi.org/10.1007/s00108-016-0122-y

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  • DOI: https://doi.org/10.1007/s00108-016-0122-y

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