The goals of palliative care are fairly straightforward-to provide comfort and symptom relief to patients who have been diagnosed with a life-ending disease. Respiratory terminal care and respiratory symptom management provided in a thoughtful and consistent manner can reduce fear and reduce anxiety. RTs can aid the patient and the family by helping them understand the disease progression and by providing an environment more conducive to the final goal of a "good death."
ShimuraS, SasakiT, SasakiH, TakishimaT.Chemical properties of bronchorrhea sputum in bronchial asthma. Chest1988;94:1211–1215.
4.
KrawtzSM, MehtaAC, VijayakumarS, StollerJK. Palliation of massive bronchorrhea (letter). Chest1988;94:1313–1314.
5.
LemboT, DonnellyTJ. A case of pancreatic carcinoma causing massive bronchial fluid production and electrolyte abnormalities. Chest1995;108:1161–1163.
6.
ShimuraS, TakishimaT.Bronchorrhea from diffuse lymphangitic metastasis of colon carcinoma to the lung. Chest1994;105:308–310.
7.
HidakaN, NagaoK.Bronchioalveolar carcinoma accompanied by severe bronchorrhea. Chest1996;110:281–282.
8.
StockleyRA. The pathogenesis of chronic obstructive lung diseases: implications for therapy. QJM1995;88:141–146.
9.
StockleyRA. New approaches to the management of COPD. Chest2000;117:58S–62S.
10.
NormanDC, BradleySF, DorinskyPM, VergheseA.Treating respiratory infections in the elderly; current strategies and considerations. Geriatrics1997;52Suppl 1:S2–S28.
11.
GreenK, WebsterH, WatanabeS, FainsingerRL. Management of nosocomial respiratory tract infections in terminally ill cancer patients. J Palliat Care1994;10:31–34.
DewanNA, RafiqueS, KanwarB, SatpathyH, RyschonK, TillotsonGS, NiedermanMS. Acute exacerbation of COPD: factors associated with poor treatment outcome. Chest2000;117:662–671.
14.
GrossmanRF. The value of antibiotics and the outcomes of antibiotic therapy in exacerbation of COPD. Chest1998;113:249S–255S.
15.
AdamsSG, MeloJ, LutherM, AnzuetoA.Antibiotics are associated with lower relapse rates in outpatients with acute exacerbation of COPD. Chest2000;117:1345–1352.
16.
RobinsonCH, WeigleyES, MuellerDH. Basic nutrition and diet therapy. Upper Saddle River, New Jersey: Prentice-Hall; 1997.
17.
BrueraE, NeumannCM. Management of specific symptom complexes in patients receiving palliative care. CMAJ1998;158:1717–1726.
18.
RosenbergIH. Nutrition and aging. In: HazzardWR, BlassJP, EttingerWH, HalterJB, OuslanderJG, editors. Principles of geriatric medicine and gerontology. New York: McGraw-Hill; 1995.
19.
FrownfelterDL, DeanE.Principles and practices of cardiopulmonary physical therapy, 3rd ed. St Louis: Mosby; 1996.
20.
PeruzziWT, SmithB.Bronchial hygiene therapy. Crit Care Clin1995;11:79–96.
21.
AARC Clinical Practice Guidelines: Postural drainage therapy. Respir Care1991;36:1418–1426.
22.
ScanlanCL, WilkinsRL, StollerJK. Egan's fundamentals of respiratory care, 7th ed. St Louis: Mosby; 1999.
23.
BachJR.Mechanical insufflation-exsufflation: comparison of peak expiratory flows with manually assisted and unassisted coughing techniques. Chest1993;104:1553–1562.
24.
HaglerDA, TraverGA. Endotracheal saline and suction catheters: sources of lower airway contamination. Am J Crit Care1994;3:444–447.
25.
WilsonR.Positive expiratory pressure therapy: the key to effective low-cost removal of bronchial secretions. RT, Journal for Respir Care1999;12:67–68.
26.
HardyKA, AndersonBD. Noninvasive clearance of airway secretions. Respir Care Clin N Am1996;2:323–345.
27.
TarnowJL, DanielBM, ShaughnessyTE, CohenNH. Comparison of positive expiratory pressure therapy versus chest physiotherapy on outcome after unilateral lung transplantation (abstract). Chest1996;110Suppl:224S.
28.
KonstanMW, SternRC, DoershukCF. Efficacy of the Flutter device for airway mucus clearance in patients with cystic fibrosis. J Pediatr1994;124:689–693.
29.
AARC Clinical Practice Guidelines. Use of positive airway pressure adjuncts to bronchial hygiene therapy. Respir Care1993;38:516–521.
30.
NataleJE, PfeifleJ, HomnickDN. Comparison of intrapulmonary percussive ventilation and chest physiotherapy: a pilot study in patients with cystic fibrosis. Chest1994;105;1789–1793.
31.
GallonAM. Evaluation of nebulized acetylcysteine and normal saline in the treatment of sputum retention following thoracotomy. Thorax1996;51:429–432.
32.
WannerA, SalathéM, O'RiordanTG. Mucociliary clearance in the airways. Am J Respir Crit Care Med1996;154:1868–1902.
33.
RauJLJr. Respiratory care drug reference. St Louis: Mosby-Year Book; 1997.
34.
BarnesPJ. Novel approaches and targets for treatment of chronic obstructive pulmonary disease. Am J Respir Crit Care Med1999;160:S72–S79.
35.
KeatingsVM, JatakanonA, WorsdellYM, BarnesPJ. Effects of inhaled and oral glucocorticoids on inflammatory indices in asthma and COPD. Am J Respir Crit Care Med1997;155:542–548.
36.
TsangKW, HoPL, LamWK, IpMS, ChanKN, HoCS, OoiCC, YuenKY. Inhaled fluticasone reduces sputum inflammatory indices in severe bronchiectasis. Am J Respir Crit Care Med1998;158:723–727.
37.
EliassonO, EliassonA-L. The effect of corticosteroids on air exchange and oxygenation in stable COPD (abstract). Chest1999;116Suppl:338S.
38.
HowderCL. Cardiopulmonary pharmacology, 2nd ed. Baltimore: Williams & Wilkins; 1996.
39.
PellegrinoED. Emerging ethical issues in palliative care. JAMA1998;279:1521–1522.
40.
O'BrianCP. Drug addiction and drug abuse. In: GoodmanAG, et al, editors. Goodman and Gilmans the pharmacological basis of therapeutics, 9th ed. New York: McGraw Hill; 1996: 557–577.
41.
AhmedzaiS.Palliation of respiratory symptoms. In: DoyleD, HanksGWC, MacDonaldN, editors. Oxford textbook of palliative medicine, 2nd ed. New York: Oxford University Press; 1998: 611.
