[Using Fans to Relieve Dyspnea: A Systematic Review and Clinical Implications].

BACKGROUND: Dyspnea is a subjective symptom of breathing discomfort that is commonly experienced by terminally ill patients in the last few weeks of life. Fans have been used to reduce breathlessness in clinical practice for terminally ill patients. However, reviews in the systematic literature are insufficient to make definite conclusions regarding the effectiveness of this intervention and to provide a consistent protocol for clinical application.

PURPOSE: The purpose of the present study was to evaluate the effects and clinical application of using fans in dyspnea patients.

METHODS: A systematic review was used. Relevant articles published prior to September 2017 were retrieved from electronic databases including PubMed, CINAHL, MEDLINE, PsycINFO, and Cochrane CENTRAL. Keywords and MeSH terms were identified for each PICO (participant, intervention, comparison, outcome) element, including dyspnea, breathless, breath shortness, breathing difficulty or labored respiration, fan, and scale. A total of 41 articles that matched the search criteria were extracted. After screening the topics, deleting repetitions, and doing critical appraisals, three randomized controlled trials were selected for further analysis. The GRADE (grading of recommendations assessment, development and evaluation) quality of evidence rating was intermediate.

RESULTS: The systematic review of the three articles revealed that a fan set at low speed with facial cooling of the 2nd and 3rd branches of the trigeminal nerve as soon as possible for 5 minutes and at a distance that is comfortable for the participant may relieve subjective feelings of dyspnea in nonhypoxic patients (e.g., cardiopulmonary disease and cancer) better than drugs and oxygen treatment alone.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Reducing the subjective feelings of dyspnea is the first step for nonhypoxic patients. Using a fan to relieve dyspnea is an evidence-based, non-invasive, economical, and effective nonpharmacological palliative intervention.