Effectiveness and safety of morphine administration for refractory dyspnoea among hospitalised patients with advanced heart failure: the Morphine-HF study

Autor: Yasuhiro Hamatani, Moritake Iguchi, Kenji Moriuchi, Yuta Anchi, Yasutaka Inuzuka, Ryusuke Nishikawa, Kiyotaka Shimamura, Hirokazu Kondo, Hibiki Mima, Yugo Yamashita, Kensuke Takabayashi, Kotoe Takenaka, Kengo Korai, Yuichi Kawase, Ryosuke Murai, Hidenori Yaku, Kazuya Nagao, Mariko Kitano, Yuya Aono, Takeshi Kitai, Yukihito Sato, Takeshi Kimura, Masaharu Akao
Rok vydání: 2023
Předmět:
Zdroj: BMJ Supportive & Palliative Care. :spcare-2023
ISSN: 2045-4368
2045-435X
DOI: 10.1136/spcare-2023-004247
Popis: ObjectivesMorphine is effective in alleviating dyspnoea in patients with cancer. We aimed to investigate the effectiveness and safety of morphine administration for refractory dyspnoea in patients with advanced heart failure (HF).MethodsWe conducted a multicentre, prospective, observational study of hospitalised patients with advanced HF in whom morphine was administered for refractory dyspnoea. Morphine effectiveness was evaluated by dyspnoea intensity changes, assessed regularly by both a quantitative subjective scale (Visual Analogue Scale (VAS; graded from 0 to 100 mm)) and an objective scale (Support Team Assessment Schedule—Japanese (STAS-J; graded from 0 to 4 points)). Safety was assessed by vital sign changes and new-onset severe adverse events, including nausea, vomiting, constipation and delirium based on the Common Terminology Criteria for Adverse Events.ResultsFrom 15 Japanese institutions between September 2020 and August 2022, we included 28 hospitalised patients with advanced HF in whom morphine was administered (mean age: 83.8±8.7 years, male: 15 (54%), New York Heart Association class IV: 26 (93%) and mean left ventricular ejection fraction: 38%±19%). Both VAS and STAS-J significantly improved from baseline to day 1 (VAS: 67±26 to 50±31 mm; p=0.02 and STAS-J: 3.3±0.8 to 2.6±1.1 points; p=0.006, respectively), and thereafter the improvements sustained through to day 7. After morphine administration, vital signs including blood pressure, pulse rate and oxygen saturation did not change, and no new-onset severe adverse events occurred through to day 7.ConclusionsThis study suggested acceptable effectiveness and safety for morphine administration in treating refractory dyspnoea in hospitalised patients with advanced HF.
Databáze: OpenAIRE
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