Continuous Intravenous Morphine Infusion for Severe Dyspnea in Terminally Ill Interstitial Pneumonia Patients

Objective The aims of this study were to evaluate the efficacy and safety of continuous morphine infusion for dyspnea in patients with acute exacerbation (AE) of end-stage interstitial pneumonia (IP). Methods We conducted a retrospective study. Based on the subjective clinical effectiveness ratings of good, moderate, poor, or unknown, the efficacy of continuous morphine infusion treatment was evaluated as defined as symptom relief that was good or moderate. Patients This study included 22 consecutive opioid-naive patients who received continuous morphine infusion in the palliative treatment of dyspnea resulting from AE-IP. Results Of 22 patients, nine achieved good dyspnea relief, eight had moderate relief, four had a poor response and one response was unknown within 24 hours of starting morphine infusion. Using an operational definition of dyspnea relief that was rated good or moderate, the efficacy rate of morphine was 77% (n=17). There was a significant change in the respiratory rate (25 respirations per minute at baseline vs. 17 respirations per minute after 12 hours, p=0.02), however, none of the patients studied had fewer than eight respirations per minute. Conclusion We conclude that continuous morphine infusion is an effective and safe therapy for severe dyspnea in terminal AE-IP patients without any serious adverse events.