Systematic review and meta-analysis on face-directed fan therapy for dyspnea in advanced disease

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Respiratory care Published May 5, 2026 Medically reviewed May 8, 2026 Study authors: Pereira Rafael Alvim, Barcellos Gabriel, Lenz Gabriel, Christmann Andreia, de Mello Marina Alves Jac… PubMed ↗ DOI ↗ By Dr. Sofia Müller, MD · Lifespan & Whole-Person Care

Key Takeaway

Consider fan therapy for immediate dyspnea relief in advanced disease, but note the evidence is preliminary and long-term benefits are unclear.

This is a systematic review and meta-analysis of face-directed fan therapy for dyspnea in adults with advanced disease, such as cancer, COPD, interstitial lung disease, or heart failure. The analysis included 463 subjects from supportive and palliative care settings. The authors synthesized evidence on dyspnea severity, breathing frequency, and oxygen saturation, comparing fan therapy to sham interventions, usual care, or no intervention.

The meta-analysis found that fan therapy significantly reduced immediate dyspnea compared to control, with a standardized mean difference (SMD) of -1.33 (95% CI -2.12 to -0.53, p = .001). However, no statistically significant benefit was observed for cumulative short-term dyspnea (SMD = -0.10, 95% CI -0.41 to 0.21, p = .53), breathing frequency (SMD = -0.73, 95% CI -1.81 to 0.36, p = .19), or oxygen saturation (SMD = 0.44, 95% CI -0.21 to 1.08, p = .19).

The authors noted high heterogeneity (I² = 91%) and that long-term benefits are still unclear. They emphasized that larger, multi-center RCTs with standardized outcomes are necessary. Safety data were not reported, but fan therapy was described as well-tolerated.

Practice relevance is restrained: fan therapy is a safe, affordable, and well-tolerated intervention that may quickly relieve dyspnea in supportive and palliative care settings, but the evidence is preliminary and requires further validation.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedMay 2026

PMID41761933

View Original Abstract ↓

BACKGROUND: Up to 70% of patients near the end of their lives experience dyspnea, a common and upsetting symptom of advanced disease. Fan therapy is a straightforward nonpharmacologic intervention that may provide symptom relief, although trial results have been mixed. To address this uncertainty, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), including both parallel-group and crossover designs, evaluating face-directed fan therapy in adults with advanced disease, such as advanced cancer, COPD, interstitial lung disease, or heart failure. METHODS: We searched PubMed, Embase, and Cochrane CENTRAL from inception to August 2025 for RCTs evaluating face-directed fan therapy in adults with advanced disease. Eligible comparators included sham interventions, usual care, or no intervention. Primary outcome was change in dyspnea severity scores; secondary outcomes included breathing frequency and oxygen saturation. Random-effects meta-analysis was used to calculate standardized mean differences (SMDs) with 95% CIs. RESULTS: Twelve RCTs with 463 subjects were included. Fan therapy significantly reduced immediate dyspnea compared with control (SMD = -1.33, 95% CI -2.12 to -0.53, = .001), although heterogeneity was high ( = 91%). No statistically significant benefit was observed for cumulative short-term dyspnea (SMD = -0.10, 95% CI -0.41 to 0.21, = .53), breathing frequency (SMD = -0.73, 95% CI -1.81 to 0.36, = .19), or oxygen saturation (SMD = 0.44, 95% CI -0.21 to 1.08, = .19). CONCLUSIONS: In subjects with advanced disease, fan therapy is a safe, affordable, and well-tolerated intervention that quickly relieves dyspnea, especially in supportive and palliative care settings. Larger, multi-center RCTs with standardized outcomes are necessary to elucidate sustained effects, as its long-term benefits are still unclear.