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Airflow relieves chronic breathlessness in people with advanced disease: an exploratory systematic review and meta-analyses

Swan, Flavia; Newey, Alison; Bland, Martin; Allgar, Victoria; Booth, Sara; Bausewein, Claudia; Yorke, Janelle; Johnson, Miriam

Authors

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Dr Flavia Swan F.Swan@hull.ac.uk
Research fellow in cancer rehabilitation

Alison Newey

Martin Bland

Victoria Allgar

Sara Booth

Claudia Bausewein

Janelle Yorke

Abstract

Background:
Chronic breathlessness is a neglected symptom of advanced diseases.

Aim:
To examine the effect of airflow for chronic breathlessness relief.

Design:
Exploratory systematic review and meta-analysis.

Data sources:
Medline, CINAHL, AMED and Cochrane databases were searched (1985–2018) for observational studies or randomised controlled trials of airflow as intervention or comparator. Selection against predefined inclusion criteria, quality appraisal and data extraction was conducted by two independent reviewers with access to a third for unresolved differences. ‘Before and after’ breathlessness measures from airflow arms were analysed. Meta-analysis was carried out where possible.

Results:
In all, 16 of 78 studies (n = 929) were included: 11 randomised controlled trials of oxygen versus medical air, 4 randomised controlled trials and 1 fan cohort study. Three meta-analyses were possible: (1) Fan at rest in three studies (n = 111) offered significant benefit for breathlessness intensity (0–100 mm visual analogue scale and 0–10 numerical rating scale), mean difference −11.17 (95% confidence intervals (CI) −16.60 to −5.74), p = 0.06 I2 64%. (2) Medical air via nasal cannulae at rest in two studies (n = 89) improved breathlessness intensity (visual analogue scale), mean difference −12.0 mm, 95% CI −7.4 to −16.6, p 

Journal Article Type Article
Publication Date Jun 1, 2019
Journal Palliative Medicine
Print ISSN 0269-2163
Electronic ISSN 1477-030X
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 33
Issue 6
Pages 618-633
Institution Citation Swan, F., Newey, A., Bland, M., Allgar, V., Booth, S., Bausewein, C., …Johnson, M. (2019). Airflow relieves chronic breathlessness in people with advanced disease: an exploratory systematic review and meta-analyses. Palliative medicine, 33(6), 618-633. https://doi.org/10.1177/0269216319835393
DOI https://doi.org/10.1177/0269216319835393
Keywords Dyspnoea; Self-management; Review; Airflow
Publisher URL https://journals.sagepub.com/doi/10.1177/0269216319835393
Additional Information This is the accepted manuscript of an article published in Palliative medicine, 2019. The version of record is available at the DOI link in this record.

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