Lung cancer

Fan-tastic intervention for chronic breathlessness

Patients with breathlessness are using hand-held fans to delay the use of oxygen therapy and inhaled beta-agonists, according to a secondary analysis of clinical trials in the area.

The trials included qualitative interviews with 133 patients with non-malignant diseases such as COPD and malignant diseases including lung cancer, and 72 carers.

The study found 72% of patients perceived some benefit from the use of a hand-held fan and another 10% of patients reported a significant benefit.

Patients typically described the main benefit of the fans was in improving their recovery time after physical activity. Carers also reported similar observations.

Fans were used as either a supplement to other therapy or as a first-line strategy before escalating to medications or oxygen.

The study authors concluded fans should be routinely offered to breathless patients given their low cost, ease of use and minimal risks, especially when compared to oxygen therapy.

However more research was required on the mechanism of action of fans and how to optimise variables such as the timing, duration, positioning and frequency of their use.

“Airflow and cooling from the fan have been postulated to influence afferent sources for respiratory sensation by stimulating upper airway ‘flow’ receptors or trigeminal skin receptors,” the study said.

“Recent preliminary neuroimaging data indicate that facial airflow may modify sensory attention involved in the central perception of breathlessness.”

Some patients suggested the benefit they received might be due to distraction, relaxation or a greater sense of confidence and control, however the authors commented they were legitimate self-management strategies in their own right.

They said ideally fans would be highly portable, quiet, robust and allow for easy battery change.

There was no indication that the perception of benefit from fan use was different in patients with different diagnoses.

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