Journal of Pain and Symptom Management
Volume 43, Issue 4 , Pages 771-782, April 2012

Dyspnea in Idiopathic Pulmonary Fibrosis: A Systematic Review

  • Christopher J. Ryerson, MD

      Affiliations

    • Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA
    • Corresponding Author InformationAddress correspondence to: Christopher J. Ryerson, MD, 505 Parnassus Avenue, Box 0111, San Francisco, CA 94143, USA.
    • ,
  • DorAnne Donesky, PhD, RN

      Affiliations

    • Department of Physiological Nursing, School of Nursing, University of California at San Francisco, San Francisco, California, USA
    • ,
  • Steven Z. Pantilat, MD

      Affiliations

    • Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA
    • ,
  • Harold R. Collard, MD

      Affiliations

    • Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, California, USA

Accepted 27 April 2011. published online 30 January 2012.

Abstract 

Context

Little is known about the treatment and correlates of dyspnea in idiopathic pulmonary fibrosis (IPF).

Objectives

The objective of this systematic review was to summarize the literature regarding the treatment and correlates of dyspnea in IPF.

Methods

MEDLINE, EMBASE, and all Evidence-Based Medicine Reviews were searched for publications that evaluated treatment or correlates of dyspnea in IPF. Reference lists and recent review articles also were searched.

Results

The heterogeneity of included studies did not permit meta-analysis. Dyspnea improved in studies of sildenafil, pulmonary rehabilitation, and prednisone with colchicine. Additional studies of these three treatments, however, found discordant results. One study suggested that assisted ventilation delivered by facemask improved exertional dyspnea. Oxygen and opioids improve dyspnea in other chronic lung diseases, but data in IPF are limited. Correlates of dyspnea included functional and physiological measures and comorbid diseases.

Conclusion

Sildenafil and pulmonary rehabilitation should be considered as potential therapies for dyspnea in selected patients with IPF. Supplemental oxygen and opioids may be additional potential therapies; however, the evidence supporting their use is weak. Additional research should focus on the management of functional status and comorbidities as potential treatments for dyspnea.

Key Words: Dyspnea, idiopathic pulmonary fibrosis, systematic review

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PII: S0885-3924(11)00764-0

doi:10.1016/j.jpainsymman.2011.04.026

Journal of Pain and Symptom Management
Volume 43, Issue 4 , Pages 771-782, April 2012

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