| Popis: |
Respiratory symptoms other than breathlessness are prevalent in palliative care patients suffering from cancer or chronic lung disease, including chronic obstructive pulmonary disease, bronchiectasis, and cystic fibrosis. Cough may cause physical and psychological morbidity with impaired quality of life. In chronic obstructive pulmonary disease, chronic cough and sputum are associated with disease progression and poorer prognosis. Recommendations on the symptomatic treatment of cough are based on limited evidence in palliative care settings, expert consensus, and studies involving other patients with chronic cough. Novel antitussive agents are being developed with more understanding of the role of ion channels in cough mechanism. Airway hypersecretion due to chronic inflammation and infection is common in chronic lung disease and the use of mucoactive agents may have a modest benefit on acute exacerbations and quality of life. Massive hypersecretion as in bronchorrhoea is uncommon, but can be distressing with no standard treatment. The choice of managing the patient with malignant pleural effusion includes repeated thoracocentesis, pleurodesis, or an intrapleural catheter, depending on the patient’s predicted survival and other factors. Haemoptysis is often alarming to patients and their families. History taking, physical examination, and a chest radiograph are informative, and guide the treatment plan in most of the patients. Other imaging and invasive interventions should be carefully considered in patients when evaluating whether it is feasible to stop massive bleeding from a localized site. |
