PALLIATIVE NON-INVASIVE VENTILATION IN END-STAGE DYSPNEA OF INTERSTITIAL LUNG DISEASES: INTEGRATIVE REVIEW

Abstract

Introduction: Interstitial lung diseases (ILDs) are a large and heterogeneous group of pathologies that lead to inflammation and fibrosis of the lung parenchyma. However, only a portion of them progress to fibrosis despite anti-fibrotic treatment, making palliative care fundamental for the relief of respiratory symptoms in these patients. Among these symptoms, dyspnea is the most common and has pharmacological therapy as the cornerstone of its treatment; however, non-invasive ventilation (NIV) is becoming a therapeutic alternative in these patients. Objective: To gather studies on NIV in the palliative care of patients with ILD and discuss its impact on end-of-life quality and dyspnea relief. Methodology: This is an integrative review, in which a bibliographic survey was conducted in the Public Medline (PubMed) and Virtual Health Library (VHL) databases. Results: 29 articles were included, 17 from VHL and 12 from PubMed. After applying the inclusion and exclusion criteria, a total of 8 articles were selected, 7 from PubMed and 1 from BVS. Conclusion: The studies found discussed the positive and negative effects of NIV at the end of life and did not observe superiority compared to conventional treatment with opioids and benzodiazepines. Therefore, it can be concluded that the scarcity of studies on the subject and the still incipient literature do not provide sufficient data on the formal recommendation of NIV as a treatment for dyspnea in this patient profile, and it should only be recommended in specific situations and in a systematic way.