Airflow for reducing breathlessness in people with serious respiratory illness: a systematic review

Background Increased airflow is reported as helpful in reducing the sensation of breathlessness. This systematic review aimed to assess the effectiveness of airflow on breathlessness (primary outcome, measured using a validated tool at rest or during exercise) and health related quality of life (secondary outcome) in people with serious respiratory illness. Methods We searched Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials in August 2022 updated in May 2025. Results Ten studies (11 reports) were identified involving 413 participants with chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, and asthma. A (handheld) fan, a pedestal fan and the PneumoCool devicewere tested. Settings included laboratory (1 study), hospital (2 studies), during exercise tests (3 studies), or daily life settings (4 studies). The primary outcomes were measured between 5 min after fan use and on day 60 after two months fan use in everyday life. Risk of bias was high in all studies. Due to heterogeneity and small sample sizes, meta-analyses were not feasible. Overall, the evidence was mixed with an overall beneficial effect of fan use in studies assessing the acute effects compared to assessment of long-term effects of fan use after 14–60 days. Health related quality of life was only reported in one study with no improvement. Conclusion The results suggest a beneficial effect of a (handheld) fan for the relief of breathlessness in people with serious respiratory illness. A fan could be an additional treatment option in the self-management of breathlessness.