<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112018000400383</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2018.04.006</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Cuidados paliativos para pacientes con insuficiencia respiratoria crónica]]></article-title>
<article-title xml:lang="en"><![CDATA[Palliative care for patients with chronic respiratory failure]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez de Llano]]></surname>
<given-names><![CDATA[Luis Alejandro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Lucus Augusti Servicio de Neumología ]]></institution>
<addr-line><![CDATA[Lugo ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2018</year>
</pub-date>
<volume>32</volume>
<numero>4</numero>
<fpage>383</fpage>
<lpage>385</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112018000400383&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112018000400383&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112018000400383&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La creciente prevalencia de enfermedades respiratorias crónicas y su más larga supervivencia han motivado que aumente el número de pacientes en situación avanzada de la enfermedad y en techo terapéutico. Sin embargo, este hecho epidemiológico no se ha acompañado de un desarrollo paralelo de programas de cuidados paliativos, lo que motiva que los enfermos que se encuentran en esta situación no reciban los cuidados médicos óptimos para asegurar su confort y evitar ingresos sucesivos que poco aportan a su pronóstico y calidad de vida. La experiencia del Hospital Lucus Agusti revela que el 7% del total de ingresos de neumología corresponden a pacientes con enfermedad crónica respiratoria avanzada no neoplásica, que solo el 65% de ellos reciben tratamiento paliativo de sus síntomas y que la práctica totalidad fallece en el hospital. Es necesario poner en práctica proyectos que no solo involucren a neumólogos, sino también a personal de enfermería, médicos de atención primaria, de hospitalización a domicilio y personal del hospital de día.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT The increasing prevalence of chronic respiratory diseases and the longer survival of patients with these disorders have lead to a rise in the number of individuals in a terminal condition with no chances of responding to additional medication. Nevertheless, this epidemiological fact has not been accompanied by a parallel development of palliative care programmes, and this prevents the patients from receiving optimal medical care to ensure their well-being and to avoid further unnecessary admissions to hospital. Our local experience in the Lucus Augusti University Hospital reveals that 7% of the admissions to the respiratory ward correspond to patients with advanced and non-neoplastic chronic respiratory disorders. Only 65% of these patients benefit from a well-structured palliative care plan and practically all of them die in the hospital. Altogether, these data highlight the need for a strategy that involves not only pneumologists but also general practitioners, nurses and palliative care physicians.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[EPOC]]></kwd>
<kwd lng="es"><![CDATA[Fibrosis pulmonar idiopática]]></kwd>
<kwd lng="es"><![CDATA[Tratamiento paliativo]]></kwd>
<kwd lng="en"><![CDATA[COPD]]></kwd>
<kwd lng="en"><![CDATA[Idiopathic pulmonary fibrosis]]></kwd>
<kwd lng="en"><![CDATA[Palliative care]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miravitlles]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Soriano]]></surname>
<given-names><![CDATA[JB]]></given-names>
</name>
<name>
<surname><![CDATA[García-Río]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities]]></article-title>
<source><![CDATA[Thorax]]></source>
<year>2009</year>
<volume>64</volume>
<page-range>863-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Solanes]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Casán]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sangenís]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Factores de riesgo de mortalidad en la EPOC]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2007</year>
<volume>43</volume>
<page-range>445-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Raghu]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Weycker]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Edelsberg]]></surname>
<given-names><![CDATA[WZ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Incidence and prevalence of idiopathic pulmonary &#64257;brosis]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2006</year>
<volume>174</volume>
<page-range>810-6</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Navaratnam]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Fleming]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[West]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The rising incidence of idiopathic pulmonary &#64257;brosis in the UK]]></article-title>
<source><![CDATA[Thorax]]></source>
<year>2011</year>
<volume>66</volume>
<page-range>462-7</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ley]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Collard]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
<name>
<surname><![CDATA[King]]></surname>
<given-names><![CDATA[TE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical course and prediction of survival in idiopathic pulmonary &#64257;brosis]]></article-title>
<source><![CDATA[Am J Respir Crit Care Med]]></source>
<year>2011</year>
<volume>183</volume>
<page-range>431-40</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rocker]]></surname>
<given-names><![CDATA[GM]]></given-names>
</name>
<name>
<surname><![CDATA[Sinuff]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Horton]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Advanced chronic obstructive pulmonary disease: innovative approaches to palliation]]></article-title>
<source><![CDATA[J Palliative Med]]></source>
<year>2007</year>
<volume>10</volume>
<page-range>783-5</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jennings]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[AN]]></given-names>
</name>
<name>
<surname><![CDATA[Higgins]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A systematic review of the use of opioids in the management of dyspnoea]]></article-title>
<source><![CDATA[Thorax]]></source>
<year>2002</year>
<volume>57</volume>
<page-range>939-44</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Abernethy]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Currow]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Frith]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Randomised, double blind, placebo controlled crossover trial of sustained release morphine for the management of refractory dyspnoea]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2003</year>
<volume>327</volume>
<page-range>523-8</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martins]]></surname>
<given-names><![CDATA[RT]]></given-names>
</name>
<name>
<surname><![CDATA[Currow]]></surname>
<given-names><![CDATA[DC]]></given-names>
</name>
<name>
<surname><![CDATA[Abernethy]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Effects of low-dose morphine on perceived sleep quality in patients with refractory breathlessness: a hypothesis generating study]]></article-title>
<source><![CDATA[Respirology]]></source>
<year>2016</year>
<volume>21</volume>
<page-range>386-91</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Allcroft]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Margitanovic]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Greene]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The role of benzodiazepines in breathlessness: a single site, open label pilot of sustained release morphine together with clonazepam]]></article-title>
<source><![CDATA[J Palliat Med]]></source>
<year>2013</year>
<volume>16</volume>
<page-range>741-4</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boyden]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Connor]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<name>
<surname><![CDATA[Otolorin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Nebulized medications for the treatment of dyspnea: a literature review]]></article-title>
<source><![CDATA[J Aerosol Med Pulm Drug Deliv]]></source>
<year>2015</year>
<volume>28</volume>
<page-range>1-19</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Xaubet]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ancochea]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bollo]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sociedad Española de Neumología y Cirugía Torácica (SEPAR) Research Group on Diffuse Pulmonary Diseases. Guidelines for the diagnosis and treatment of idiopathic pulmonary &#64257;brosis. Sociedad Española de Neumología y Cirugía Torácica (SEPAR) Research Group on Diffuse Pulmonary Diseases]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2013</year>
<volume>49</volume>
<page-range>343-53</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="">
<collab>Global Initiative for Chronic Obstructive Lung Disease (GOLD)</collab>
<source><![CDATA[GOLD 2017 Global Strategy for the Diagnosis, Management and Prevention of COPD]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meffert]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Hatami]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Xander]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Palliative care needs in COPD patients with or without cancer: an epidemiological study]]></article-title>
<source><![CDATA[Eur Respir J]]></source>
<year>2015</year>
<volume>46</volume>
<page-range>663-70</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tavares]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Jarrett]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Hunt]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Palliative and end-of-life care conversations in COPD: a systematic literature review]]></article-title>
<source><![CDATA[ERJ Open Res]]></source>
<year>2017</year>
<volume>3</volume>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Higginson]]></surname>
<given-names><![CDATA[IJ]]></given-names>
</name>
<name>
<surname><![CDATA[Reilly]]></surname>
<given-names><![CDATA[CC]]></given-names>
</name>
<name>
<surname><![CDATA[Bajwah]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[GUIDE Care Project. Which patients with advanced respiratory disease die in hospital? A 14-year population-based study of trends and associated factors]]></article-title>
<source><![CDATA[BMC Med]]></source>
<year>2017</year>
<volume>15</volume>
<page-range>19</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nieto Cano]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Golpe Gómez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez de Llano]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The need for palliative care in chronic respiratory patients with non-malignant disease]]></article-title>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>2018</year>
<volume>54</volume>
<page-range>57</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Beernaert]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Deliens]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Referral to palliative care in COPD and other chronic diseases: a population-based study]]></article-title>
<source><![CDATA[Respir Med]]></source>
<year>2013</year>
<volume>107</volume>
<page-range>1731-9</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dumont]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Blondeau]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Turcotte]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The use of palliative sedation: a comparison of attitudes of French-speaking physicians from Quebec and Switzerland]]></article-title>
<source><![CDATA[Palliat Support Care]]></source>
<year>2015</year>
<volume>13</volume>
<page-range>839-47</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weissman]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Meier]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Identifying patients in need of a palliative care assessment in the hospital setting: a consensus report from the Center to Advance]]></article-title>
<source><![CDATA[Palliative Care. J Palliat Med]]></source>
<year>2011</year>
<volume>14</volume>
<page-range>17-23</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
