High-Flow Oxygen and Bilevel Positive Airway Pressure for Persistent Dyspnea in Patients With Advanced Cancer: A Phase II Randomized Trial David Hui,

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Presentation transcript:

High-Flow Oxygen and Bilevel Positive Airway Pressure for Persistent Dyspnea in Patients With Advanced Cancer: A Phase II Randomized Trial David Hui, MD, MSc, Margarita Morgado, MA, Gary Chisholm, MS, Laura Withers, MBA, RRT, CPFT, Quan Nguyen, BS, RRT, Clarence Finch, MBA, MHA, RRT, Susan Frisbee-Hume, MSN, Eduardo Bruera, MD Journal of Pain and Symptom Management Volume 46, Issue 4, Pages 463-473 (October 2013) DOI: 10.1016/j.jpainsymman.2012.10.284 Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 1 Study flow chart. BiPAP = bilevel positive airway pressure; HFO = high-flow oxygen. Journal of Pain and Symptom Management 2013 46, 463-473DOI: (10.1016/j.jpainsymman.2012.10.284) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 2 Change in dyspnea scores with high-flow oxygen and BiPAP. As compared with baseline, BiPAP was associated with an average improvement in (a) the dyspnea numeric rating scale of 3.2 (P = 0.004) and (b) the modified Borg scale of 1.5 (P = 0.13). High-flow oxygen also was associated with an average improvement in (c) the numeric rating scale of 1.9 (P = 0.02) and (d) the modified Borg scale of 2.1 (P = 0.007). Intention-to-treat analysis revealed no significant differences between the two devices with the dyspnea numeric rating scale (P = 0.32) and the modified Borg scale (P = 0.29). BiPAP = bilevel positive airway pressure. Journal of Pain and Symptom Management 2013 46, 463-473DOI: (10.1016/j.jpainsymman.2012.10.284) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions

Fig. 3 Global Symptom Evaluation for HFO and BiPAP. Patients were asked to provide their overall impression about the change in dyspnea level (“worse,” “about the same,” or “better”) using the Global Symptom Evaluation scale. Consistent with the dyspnea scores, a majority of patients reported that HFO and BiPAP were efficacious in relieving their dyspnea. HFO = high-flow oxygen; BiPAP = bilevel positive airway pressure. Journal of Pain and Symptom Management 2013 46, 463-473DOI: (10.1016/j.jpainsymman.2012.10.284) Copyright © 2013 U.S. Cancer Pain Relief Committee Terms and Conditions