말기암환자에서 불응성 호흡곤란 완화를 위한 Furosemide 흡입치료 -대한가정의학회 완화의학연구회 세미나에 기초한- = Applying Inhaled Furosemide for Refractory Breathlessness in Terminally-ill Cancer Patients - Based on Seminar of Palliative Medicine Research Group, The Korean Academy of Family Medicine -

다국어 초록 (Multilingual Abstract)

Breathlessness is a frequent and distressing symptom in terminal cancer patients. Refractory breathlessness is defined as a state that does not respond to conventional disease-specific therapy with an exclusion of reversible underlying causes, and the main classes of symptomatic drug treatments include opioids and benzodiazepines. Korean Family Medicine Palliative Medicine Research Group discussed two terminal cancer patients in whom severe breathlessness with different causes were treated with inhalation of nebulized furosemide, which is an emerging option of palliative treatment. It still remains unclear how it becomes effective or how much it is effective, therefore, its routine use seems to be somewhat early. Nevertherless, if a patient with intractable breathlessness does not have a marked obstructive airway lesion, its use should be considered. Based on the discussion in the seminar, we want to share our experience of the application of inhaled furosemide with other palliative care practitioners and strongly recommend further research on this topic in the future.

참고문헌 (Reference)

1 곽정임, "완화 의학에서의 평가도구" 한국호스피스완화의료학회 12 (12): 177-193, 2009

2 Dorman S, "Which measurement scales should we use to measure breathlessness in palliative care? A systematic review" 21 (21): 177-191, 2007

3 Mercadante S, "The course of symptom frequency and intensity in advanced cancer patients followed at home" 20 (20): 104-112, 2000

4 Wilcock A, "Randomised, placebo controlled trial of nebulised furosemide for breathlessness in patients with cancer" 63 (63): 872-875, 2008

5 Bianco S, "Prevention of exercise-induced bronchoconstriction by inhaled frusemide" 2 (2): 252-255, 1988

6 Newton PJ, "Nebulized furosemide for the management of dyspnea: does the evidence support its use?" 36 (36): 424-441, 2008

7 Stone P, "Nebulized frusemide for dyspnoea" 8 (8): 258-, 1994

8 Ben-Aharon I, "Interventions for alleviating cancer-related dyspnea: a systematic review" 26 (26): 2396-2404, 2008

9 Kohara H, "Effect of nebulized furosemide in terminally ill cancer patients with dyspnea" 26 (26): 962-967, 2003

10 American Thoracic Society, "Dyspnea. Mechanisms, assessment, and management: a consensus statement" American Thoracic Society 159 (159): 321-340, 1999

11 Reuben DB, "Dyspnea in terminally ill cancer patients" 89 (89): 234-236, 1986

12 Thomas JR, "Clinical management of dyspnoea" 3 (3): 223-228, 2002

13 Cachia E, "Breathlessness in cancer patients" 44 (44): 1116-1123, 2008