Swan Flavia, Booth Sara
aSEDA Research Group, Hull York Medical School, University of Hull, Hull bAssociate Lecturer, University of Cambridge, Cambridge CB2 200, UK.
Curr Opin Support Palliat Care. 2015 Sep;9(3):206-11. doi: 10.1097/SPC.0000000000000160.
Chronic refractory breathlessness is a major cause of suffering to people with advanced stage cardiorespiratory and some neurodegenerative diseases. It is a frightening, distressing and disabling symptom that imposes significant burdens on family members. Evidence is mounting for the role of facial or nasal airflow for the relief of chronic refractory breathlessness in those patients with mild hypoxaemia or normoxaemia. Airflow can be delivered from a cylinder of compressed medical air via face mask or nasal cannulae or a hand-held fan. The hand-held fan offers patients a simple, low-cost, self-management strategy that is not associated with any known risks. Therefore, it is timely and relevant to review the research available for the efficacy and appropriateness of facial or nasal airflow.
There is sufficient review evidence available to suggest that airflow from the hand-held fan or medical air can provide clinically relevant and discernible relief of chronic refractory breathlessness at rest in patients with advanced diseases.
The hand-held fan should be considered as one of the first interventions to try in management plans for patients who present with mild hypoxaemia or normoxaemia and chronic refractory breathlessness at rest or on minimal exertion. Emerging evidence indicates that airflow from the hand-held fan may also have an important role with exertion-induced breathlessness, decreasing distress and speeding recovery time after exercise, thereby helping patients self-manage their symptoms during everyday general activity and plan for crises of breathlessness, secure in the knowledge that they have a tangible, easily portable device to try in any circumstances.
慢性难治性呼吸困难是晚期心肺疾病及某些神经退行性疾病患者痛苦的主要原因。它是一种令人恐惧、痛苦且致残的症状，给家庭成员带来了沉重负担。越来越多的证据表明，对于轻度低氧血症或正常氧血症的患者，面部或鼻腔气流在缓解慢性难治性呼吸困难方面发挥着作用。气流可通过面罩、鼻导管或手持风扇从压缩医用空气罐输送。手持风扇为患者提供了一种简单、低成本的自我管理策略，且不存在任何已知风险。因此，及时回顾关于面部或鼻腔气流的疗效和适用性的现有研究具有重要意义。
有足够的综述证据表明，手持风扇或医用空气产生的气流能够为晚期疾病患者在静息状态下的慢性难治性呼吸困难提供临床上相关且可察觉的缓解。
对于出现轻度低氧血症或正常氧血症且在静息或轻微运动时伴有慢性难治性呼吸困难的患者，手持风扇应被视为管理计划中首先尝试的干预措施之一。新出现的证据表明，手持风扇产生的气流在运动诱发的呼吸困难方面可能也具有重要作用，可减轻痛苦并缩短运动后的恢复时间，从而帮助患者在日常一般活动中自我管理症状，并为呼吸困难发作做好准备，因为他们知道自己有一个切实可行、便于携带的设备，可在任何情况下尝试使用。
