Up to 75% of dying pts experience dyspnea. Dyspnea exerts perhaps the greatest adverse effect on the pt, often even more distressing than pain. It may be caused by parenchymal lung disease, infection, effusions, pulmonary emboli, pulmonary edema, asthma, or compressed airway. While many of the causes may be treated, often the underlying cause cannot be reversed.

Interventions Underlying causes should be reversed, where possible, as long as the intervention is not more unpleasant (e.g., repeated thoracenteses) than the dyspnea. Most often the treatment is symptomatic (Table 9-3).