The use of noninvasive mechanical ventilation in the palliative care of a patient with metastatic thoracic sarcoma: case report

Palliative care is based on prevention and relief of suffering, identifying, assessing and treating pain and other physical, psychological, social and spiritual problems. Sudden dyspnea is frequently observed in terminal oncologic patients. In these cases, noninvasive ventilation can be an adequate option to control dyspnea promoting comfort and allowing patient interaction with their relatives. The aim of this article was to present the benefits of noninvasive ventilation in the palliative care setting. The case of a 29 year old patient, admitted in intensive care unit (ICU), after cesarean section delivery, for clinical treatment of acute respiratory failure is reported. Chest X-ray showed pulmonary mass in the right lung. After clinical and image investigation, metastatic thoracic sarcoma was diagnosed and palliative cares were introduced. The ICU interdisciplinary team chose to use noninvasive ventilation (modality CPAP + PSV) to relieve dyspnea and discomfort, as well as to allow interaction with her baby and family. Palliative care with noninvasive ventilation contributed to increase comfort of the patient by controlling dyspnea.