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Continuous Intravenous Morphine Infusion for Severe Dyspnea in Terminally Ill Interstitial Pneumonia Patients
Makiko Takeyasu1, Atsushi Miyamoto, Daisuke Kato
1Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Japan.
Objective:
The aims of this study were to evaluate the efficacy and safety of continuous morphine infusion for dyspnea in patients with acute exacerbation (AE) of end-stage interstitial pneumonia (IP).
Methods:
We conducted a retrospective study. Based on the subjective clinical effectiveness ratings of "good," "moderate," "poor," or "unknown," the efficacy of continuous morphine infusion treatment was evaluated as defined as symptom relief that was "good" or "moderate."
Patients:
This study included 22 consecutive opioid-naïve patients who received continuous morphine infusion in the palliative treatment of dyspnea resulting from AE-IP.
Results:
Of 22 patients, nine achieved good dyspnea relief, eight had moderate relief, four had a poor response and one response was "unknown" within 24 hours of starting morphine infusion. Using an operational definition of dyspnea relief that was rated "good" or "moderate," the efficacy rate of morphine was 77% (n=17). There was a significant change in the respiratory rate (25 respirations per minute at baseline vs. 17 respirations per minute after 12 hours, p=0.02), however, none of the patients studied had fewer than eight respirations per minute.
Conclusion:
We conclude that continuous morphine infusion is an effective and safe therapy for severe dyspnea in terminal AE-IP patients without any serious adverse events.
Insights
Continuous morphine infusion effectively relieved dyspnea in patients with acute exacerbation of end-stage interstitial pneumonia. This palliative therapy demonstrated a 77% efficacy rate with no serious adverse events, offering a safe option for symptom management.
Area of Science:
- Palliative Care
- Respiratory Medicine
- Pharmacology
Background:
- Dyspnea is a debilitating symptom in end-stage interstitial pneumonia (IP).
- Acute exacerbations (AE) of IP significantly worsen dyspnea, impacting quality of life.
- Effective symptom management is crucial in palliative care for terminal IP patients.
Purpose of the Study:
- To evaluate the efficacy of continuous morphine infusion for dyspnea in patients with AE-IP.
- To assess the safety profile of this therapeutic approach.
- To determine the effectiveness of morphine in providing symptom relief for severe dyspnea.
Main Methods:
- Retrospective study design.
- Inclusion of 22 opioid-naïve patients with AE-IP.
- Evaluation of continuous morphine infusion based on subjective clinical effectiveness ratings (good or moderate relief).
Main Results:
- Morphine infusion achieved a 77% efficacy rate (17 out of 22 patients) for dyspnea relief.
- Significant reduction in respiratory rate observed (25 to 17 breaths per minute within 12 hours, p=0.02).
- No serious adverse events were reported during the treatment period.
Conclusions:
- Continuous morphine infusion is an effective treatment for severe dyspnea in terminal AE-IP.
- The therapy is safe, with no significant adverse events noted.
- Morphine infusion offers a valuable palliative option for managing breathlessness in advanced lung disease.
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