Key result
Intranasal fentanyl (50 μg) administered prior to a 6-minute walk test significantly reduced post-activity dyspnea scores (3.83 vs 6.00; P=0.048) in palliative patients with end-stage heart failure.
Why the study?
Does intranasal fentanyl reduce activity-induced dyspnea in palliative patients with end-stage heart failure?
Does intranasal fentanyl reduce activity-induced dyspnea in palliative patients with end-stage heart failure?
Absolute Event Rate: 3.83% vs 6%
p-value: p=0.048
Intranasal fentanyl may safely reduce exertional dyspnea and tachypnea in hospitalized patients with end-stage heart failure, offering a potential palliative approach.
May reduce exertional dyspnea in end-stage HF; pilot data are hypothesis-generating and require larger RCTs before practice change.
BACKGROUND:: Dyspnea is distressing in palliative patients with end-stage heart failure and many are hospitalized to optimize this symptom. We hoped to conduct a pilot study to determine whether the administration of intranasal fentanyl would decrease activity-induced dyspnea in this patient population. METHODS:: Patients performed two 6-minute walk tests with and without the administration of 50 μg of intranasal fentanyl. Vital signs were recorded before and after each walk, as were participant reported dyspnea and adverse events scores. RESULTS:: Twenty-four patients were screened, 13 were deemed eligible, and 6 completed the study. Dyspnea scores changed from a mean of 6.00 immediately after the walk without fentanyl to a mean of 3.83 after the walk with fentanyl ( P = .048). Mean respiratory rate decreased from 21.0 to 18.7 ( P = .034) breaths per minute and was considered a favorable outcome by the participants. Distance walked did not significantly increase with the fentanyl pretreatment (136.0-144.2 m; P = .283), although the participants reported feeling better while walking a similar distance. CONCLUSIONS:: In this pilot study, the preadministration of intranasal fentanyl prior to activity in palliative, end-stage hospitalized heart failure patients, safely reduced tachypnea, and the feeling of shortness of breath. This approach may help palliate advanced heart failure patients by alleviating symptoms brought on by exertional activities.
No takes yet. Share an insight, caveat, or question.
Pilkey et al. (2018) studied Advanced Congestive Heart Failure (n=6). Intranasal fentanyl vs. Without fentanyl was evaluated on Dyspnea scores immediately after 6-minute walk test (p=0.048). Intranasal fentanyl (50 μg) administered prior to a 6-minute walk test significantly reduced post-activity dyspnea scores (3.83 vs 6.00; P=0.048) in palliative patients with end-stage heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: