Abstract:
BACKGROUND:Respiratory signs and symptoms are commonly encountered by physicians who care for cancer patients. Supplemental oxygen (SOx) has long been used for treatment of hypoxic respiratory insufficiency, but data reveal mixed efficacy results. The use and outcome patterns of technologically advanced oxygen delivery devices, such as humidified high-flow nasal oxygen (HHFNOx), are incompletely understood. METHODS:Institutional database search of the number of patient cases in which the current HHFNOx device was used, and abstraction of 183 patient medical records for usage characteristics. RESULTS:Patients have been treated with HHFNOx at Memorial Sloan Kettering Cancer Center (MSKCC) since 2008. Of the 183 patients randomly selected for our study, 72% received HHFNOx in the intensive care unit (ICU) because of hypoxia. Patients usually improved (41%) or remained stable (44%) while on the device, whereas 15% declined. At study completion, 45% of patients were living, and 55% had died. The median time on HHFNOx was 3 days (range: 1-27). A do not resuscitate (DNR) order was present in 101 (55%) patients, either before (12%) or after (43%) device utilization. The majority (78%) of these 101 patients died at MSKCC. CONCLUSION:Dyspnea is a common and important symptom in cancer patients for which SOx traditionally has had no clear basis except in select cases of hypoxia and patient preference. Our institutional experience with HHFNOx contributes to the understanding of the applications and challenges surrounding the use of new medical devices in the cancer population. Physiologic and quality-of-life benefits of HHFNOx compared with traditional oxygen delivery methods should be studied prospectively.
journal_name
J Palliat Medjournal_title
Journal of palliative medicineauthors
Epstein AS,Hartridge-Lambert SK,Ramaker JS,Voigt LP,Portlock CSdoi
10.1089/jpm.2011.0005subject
Has Abstractpub_date
2011-07-01 00:00:00pages
835-9issue
7eissn
1096-6218issn
1557-7740journal_volume
14pub_type
杂志文章abstract::We faced a challenge in providing a consistent high-quality learning experience in hospice care, especially because our community-based medical school has students rotating in hospices in six separated communities and the number of faculty with expertise in palliative care is limited. To address these concerns, a Web-...
journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/109662102320880642
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2010-06-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2012-10-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,评审
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journal_title:Journal of palliative medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2013-03-01 00:00:00
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doi:10.1089/10966210252785042
更新日期:2002-02-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2004.7.683
更新日期:2004-10-01 00:00:00
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journal_title:Journal of palliative medicine
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更新日期:2015-02-01 00:00:00
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doi:10.1089/jpm.2015.0398
更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-09-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2012.0546
更新日期:2013-09-01 00:00:00
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journal_title:Journal of palliative medicine
pub_type: 杂志文章
doi:10.1089/jpm.2009.0410
更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章
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