6
Treatment
Table 1. Definitions
Term Definition
Advanced
cancer
e American Cancer Society defines advanced cancer as "cancers that
cannot be cured" and metastatic cancer as tumors that "have usually
spread from where they started to other parts of the body." However,
not all advanced cancers are metastatic. For example, brain tumors may
be considered advanced because they are oen not curable, even in the
absence of metastasis.
In this guideline, particular emphasis was placed on studies including
patients with advanced cancer. Other patient populations were also
considered when formulating the recommendations.
Dyspnea e American oracic Society defines dyspnea as "a subjective experience
of breathing discomfort that consists of qualitatively distinct sensations
that vary in intensity." In this guideline, dyspnea is considered to be
equivalent to "breathlessness" and "air hunger."
High Flow
Nasal
Cannula
(HFNC)
Delivers a humidified, heated, air oxygen blend (allowing from 21%–
100% fraction of inspired oxygen) generating up to 60 liters/minute flow
rates through a large diameter nasal cannula.
Hypercapnia PaCO
2
≥45 mmHg
Hypoxemia Oxygen saturation (SpO
2
) <90% while breathing room air at rest, which is
equivalent to PaO
2
of <60 mmHg.
Morphine
equivalent
daily dose
(MEDD)
e total dose of opioid use per 24-hour period, taking into account both
the scheduled and rescue doses. To facilitate this calculation, different
opioids can be converted to oral morphine equivalents using standardized
ratios. 15 mg of oral morphine is equivalent to 3.75 mg of oral
hydromorphone, 5 mg of oral oxymorphone, 10 mg of oral oxycodone and
15 mg of hydrocodone. Parenteral opioids are generally 2–3× as strong as
their oral counterparts.
Non-invasive
ventilation
e American oracic Society and European Respiratory Society
Guideline defines non-invasive ventilation as "noninvasive variable positive
airway pressure (most commonly 'bilevel') devices consisting of a higher
inspiratory positive airway pressure and a lower expiratory pressure as well
as continuous positive airway pressure (CPAP) delivered using various
nasal, oronasal, and facial interfaces."
Standard
supplemental
oxygen
Conventional oxygen therapy delivered via nasal cannula or face masks —
can achieve flow rates of up to 15 liters/minute.
