Evidence map›Paper›PMID 29228935›Full record

Trial reportBMC pulmonary medicine2017

Dosimetrically administered nebulized morphine for breathlessness in very severe chronic obstructive pulmonary disease: a randomized, controlled trial.

Piotr Janowiak, Małgorzata Krajnik, Zygmunt Podolec, Tomasz Bandurski, Iwona Damps-Konstańska, Piotr Sobański, David C Currow, Ewa Jassem

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pulmonary medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 20 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Piotr JanowiakDepartment of Pneumonology and Allergology, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
Małgorzata KrajnikDepartment of Palliative Care, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, M. Curie Skłodowskiej 9, 85-094, Bydgoszcz, Poland.
Zygmunt PodolecDepartment of Aerosology and Aerosol Bioengineering, Research and Development Centre of MEDiNET, Juliusza Lea 114, 30-133, Kraków, Poland.
Tomasz BandurskiDepartment of Radiology Informatics and Statistics, Medical University of Gdańsk, Tuwima 15, 80-210, Gdańsk, Poland.
Iwona Damps-KonstańskaDepartment of Pneumonology and Allergology, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
Piotr SobańskiPalliativzentrum Hildegard, Sankt Alban-Ring 151, 4020, Basel, Switzerland.
David C CurrowFaculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia. david.currow@uts.edu.au.
Ewa JassemDepartment of Pneumonology and Allergology, Medical University of Gdańsk, Dębinki 7, 80-211, Gdańsk, Poland.
Gdańsk Medical University · PLCollegium Medicum in Bydgoszcz · PLUniversity Hospital of Basel · CHUniversity of Technology Sydney · AU

Funding

Medical University of Gdansk ST-553
6 · The paper itself

Abstract

backgroundSystemic morphine has evidence to support its use for reducing breathlessness in patients with severe chronic obstructive pulmonary disease (COPD). The effectiveness of the nebulized route, however, has not yet been confirmed. Recent studies have shown that opioid receptors are localized within epithelium of human trachea and large bronchi, a target site for a dosimetric nebulizer. The aim of this study was to compare any clinical or statistical differences in breathlessness intensity between nebulized 2.0% morphine and 0,9% NaCl in patients with very severe COPD.

methodsThe study was a double-blind, controlled, cross-over trial. Participants received morphine or NaCl during two 4-day periods. Sequence of periods was randomized. The primary outcome measure was reduction of breathlessness intensity now by ≥20 mm using a 100 mm visual analogue scale (VAS) at baseline, 15, 30, 60, 120, 180 and 240 min after daily administration, during normal activities.

resultsTen of 11 patients included completed the study protocol. All patients experienced clinically and statistically significant (p < 0.0001) breathlessness reduction during morphine nebulization. Mean VAS changes for morphine and 0.9% NaCl periods were 25.4 mm (standard deviation (SD): 9.0; median: 23,0; range: 14.0 to 41,5; confidence interval (CI): 95%) and 6.3 mm (SD: 7.8; median: 6.8; range: -11,5 to 19,5; CI: 95%), respectively. No treatment emergent adverse effects were noted. DISCUSSION: Our study showed superiority of dosimetrically administered nebulized morphine compared to NaCl in reducing breathlessness. This may have been achieved through morphine's direct action on receptors in large airways, although a systemic effect from absorption through the lungs cannot be excluded.

trial registrationRetrospectively registered (07.03.2017), ISRCTN14865597.

Indexed as

DyspneaPulmonary Disease, Chronic ObstructiveAdministration, InhalationAgedAnalgesics, OpioidDouble-Blind MethodDrug MonitoringFemaleHumansMaleMiddle AgedMorphineNebulizers and VaporizersSeverity of Illness IndexTreatment OutcomeAnalgesics, OpioidMorphine

Identifiers

PMID29228935
PMCPMC5725796
OpenAlexW2775215578

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.