Chapter

Respiratory symptoms

Lynda Brook, Emma Twigg, Amanda Venables and Claire Shaw

in Oxford Textbook of Palliative Care for Children

Second edition

Published on behalf of Oxford University Press

Published in print May 2012 | ISBN: 9780199595105
Published online July 2012 | e-ISBN: 9780199665020 | DOI: http://dx.doi.org/10.1093/med/9780199595105.003.0028

Series: Oxford Textbooks In Palliative Medicine

Respiratory symptoms

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Respiratory symptoms are extremely important in paediatric palliative care. Breathing is one of the activities of daily living, and the cessation of breathing is probably the most immediate outward sign that death has occurred. It is therefore perhaps not surprising that the symptom burden related to problems with breathing and breathlessness is complex and multidimensional. Respiratory symptoms, particularly dyspnoea and cough, are invariably listed in the top ten most prevalent and distressing symptoms in paediatric palliative care for both cancer and non-cancer patients. The significance of dyspnoea and other breathing problems in paediatric palliative care is increasingly recognized. The options for management of respiratory symptoms in paediatric palliative care are also increasing. This chapter will consider in detail the aetiology, pathophysiology, and assessment of respiratory symptoms, including differences between different diagnostic groups in terms of prevalence of specific symptoms, symptom aetiology, and impact on quality of life. We shall consider in detail the options for managing dyspnoea, including pharmacological and non-pharmacological approaches. We shall also consider the role of mechanical respiratory support and the potential benefi ts and harms of such an approach at different stages of the child’s illness journey, the potential benefits of physiotherapy and psychological approaches, and other important respiratory symptoms, such as cough, haemoptysis, and retained respiratory secretions at the end of life (‘death rattle’).

Chapter.  7531 words.  Illustrated.

Subjects: Paediatrics ; Palliative Medicine

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