4
Treatment
4. Non-pharmacologic Interventions
➤ Airflow interventions such as directing a fan at the cheek (trigeminal
nerve distribution) should be offered. (Moderate recommendation;
EB-I)
➤ Standard supplemental oxygen should be available for patients with
hypoxemia who are experiencing dyspnea (i.e., SpO
2
≤90% on room
air). (Moderate recommendation; EB-I)
➤ Supplemental oxygen is not recommended when SpO
2
>90%.
(Moderate recommendation; EB-I)
➤ A time-limited therapeutic trial of high flow nasal cannula oxygen
therapy, if available, may be offered to patients who have significant
dyspnea and hypoxemia despite standard supplemental oxygen.
(Moderate recommendation; EB-L)
➤ A time-limited therapeutic trial of non-invasive ventilation, if
available, may be offered to patients who have significant dyspnea
despite standard measures and do not have contraindications.
(Moderate recommendation; EB-L)
➤ Other non-pharmacologic measures such as breathing techniques,
posture, relaxation, distraction, meditation and education/self-
management, physical therapy, and music therapy may be offered.
(Weak recommendation; EB-L)
➤ Acupressure/reflexology, if available, may be offered. (Weak
recommendation; EB-L)
➤ Evidence remains insufficient for a recommendation for or against
pulmonary rehabilitation in patients with advanced cancer and
dyspnea.
