K.5.1.1. Midazolam versus morphine

Figure 31. Dyspnoea relief

Figure 32. Clinically relevant (grade 2 or above) adverse events at 48 hours

K.5.1.2. Morphine plus midazolam versus midazolam

Figure 33. Dyspnoea relief

Figure 34. Clinically relevant (grade 2 or above) nausea or vomiting at 48 hours

Figure 35. Clinically relevant (grade 2 or above) somnolence at 48 hours

K.5.1.3. Oxygen versus morphine or hydromorphone (NRS)

Figure 36. Dyspnoea at rest; range 0 (absent) – 10 (worst possible)

K.5.1.4. Morphine or hydromorphone versus room air (NRS)

Figure 37. Dyspnoea at rest; range 0 (absent – 10 (worst possible)

K.5.1.5. Oxygen versus room air (NRS)

Figure 38. Dyspnoea at rest; range 0 (absent) – 10 (worst possible)

K.5.2.1. Diamorphine versus morphine

Figure 39. Pain; range 0 (none) – 100 (most severe)

Figure 40. Nausea; range 0 (none) – 100 (most severe)

Figure 41. Night-time sleep quality; range 0 (none) – 100 (perfect night)

K.5.3.1. Glycopyrronium bromide versus hyoscine hydrobromide

Figure 42. Improvement in noise intensity: ‘better’ from baseline (scale same, better, worse – observational study)

Figure 43. Secretions relieved at death (‘absent’ or ‘much better’ on a 6 point scale, - prospective audit)

Figure 44. Response to drug (time from first observation until first observation of absent symptoms – observational study)

Figure 45. Improvement in relatives' distress (‘absent’ or ‘much better’ on a 6 point scale – prospective audit)

Figure 46. Length of survival (hours) – randomised controlled trial

K.5.3.2. Hyoscine butylbromide versus hyoscine hydrobromide

Figure 47. Improvement in noisy breathing (‘not audible’ or ‘only audible near the patient’ on a 4 point scale defined as effective reduction) – RCT evidence

Figure 48. Secretions relieved at death (‘absent’ or ‘much better’ on a 6 point scale, - prospective audit)

Figure 49. Improvement in relatives' distress (‘absent’ or ‘much better’ on a 6 point scale – prospective audit)

Figure 50. Worsening in level of consciousness (rating lower than ‘alert’ or ‘somnolent’) – RCT evidence

Figure 51. Improvement in confusion (for those with sufficient level of consciousness to assess) – RCT evidence

K.5.3.3. Atropine versus hyoscine hydrobromide

Figure 52. Improvement in noisy breathing (‘not audible’ or ‘only audible near the patient’ on a 4 point scale defined as effective reduction) – RCT evidence

Figure 53. Worsening in level of consciousness (rating lower than ‘alert’ or ‘somnolent’) – RCT evidence

Figure 54. Improvement in confusion (for those with sufficient level of consciousness to assess) – RCT evidence

K.5.3.4. Atropine versus hyoscine butylbromide

Figure 55. Improvement in noisy breathing (‘not audible’ or ‘only audible near the patient’ on a 4 point scale defined as effective reduction) – RCT evidence

Figure 56. Worsening in level of consciousness (rating lower than ‘alert’ or ‘somnolent’ – RCT evidence

Figure 57. Improvement in confusion (for those who sufficient level of consciousness to assess) – RCT evidence

K.5.3.5. Octreotide versus hyoscine hydrobromide

Figure 58. Improvement in noisy breathing intensity (decrease on a five point scale) – pilot cross-over RCT evidence

K.5.3.6. Atropine versus placebo

Figure 59. Improvement in noise intensity (at least 1 point score reduction on a 4 point scale ranging from ‘inaudible’ to ‘clearly audible at about 20 feet’) – RCT evidence

K.5.3.7. Hyoscine hydrobromide versus placebo

Figure 60. Increase in pain (3 point scale ‘mild’, ‘moderate’, ‘severe’) – RCT evidence

Figure 61. Increase in restlessness (3 point scale ‘mild’, ‘moderate’, ‘severe’) – RCT evidence

Figure 62. Length of survival (minutes) – RCT evidence

K.5.3.8. Glycopyrronium bromide versus hyoscine butylbromide

Figure 63. Secretions relieved at death (‘absent’ or ‘much better’ on a 6 point scale, - prospective audit)

Figure 64. Improvement in relatives' distress (‘absent’ or ‘much better’ on a 6 point scale – prospective audit)