Experience in managing refractory breathlessness in non-cancer patients undergoing palliative care

Patients with end stage organ failure suffer from a range of clinical symptoms including breathlessness. The latter is a multidimensional symptom, consisting of affective as well as physical aspects. We intend to describe the management of breathlessness outside of the context of the primary disease and describe the inputs of a Palliative Care Team in the management.

The clinical cases highlight how the three cycles of breathlessness; breathing, thinking and functioning (BTF) were addressed through a multidisciplinary team. The case series shows the utility of a simple framework (i.e. three cycles), use of morphine and the importance of rehabilitation to improve breathlessness of these patients. Assessment of the three domains of breathlessness and identification of the strongest driver and targeting the treatment strategy for individual patients through a multidisciplinary approach is effective in providing relief and improving quality of life within a short period of time.