Unrecognized suffering in the ICU: addressing dyspnea in mechanically ventilated patients

Background Intensive care unit (ICU) patients are exposed to many sources of discomfort. Although increasing attention is being given to the detection and treatment of pain, very little is given to the detection and treatment of dyspnea (defined as “breathing discomfort”). Methods Published informat...

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Bibliographic Details
Published in:Intensive care medicine 2014-01, Vol.40 (1), p.1-10
Main Authors: Schmidt, Matthieu, Banzett, Robert B., Raux, Mathieu, Morélot-Panzini, Capucine, Dangers, Laurence, Similowski, Thomas, Demoule, Alexandre
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesiology
Anxiety - diagnosis
Anxiety - etiology
Care and treatment
Caregivers
Critical Care - methods
Critical Care - standards
Critical Care Medicine
Dyspnea
Dyspnea - diagnosis
Dyspnea - etiology
Dyspnea - psychology
Emergency Medicine
Hospital patients
Humans
Intensive
Intensive care
Intensive Care Units
Lungs
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Pain
Pain - diagnosis
Pain - etiology
Pain Management - methods
Pain Medicine
Patients
Pediatrics
Pneumology/Respiratory System
Pulmonary Gas Exchange - physiology
Respiration
Respiration, Artificial - adverse effects
Respiration, Artificial - methods
Review
Tidal Volume - physiology
Visual Analog Scale
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Summary:Background Intensive care unit (ICU) patients are exposed to many sources of discomfort. Although increasing attention is being given to the detection and treatment of pain, very little is given to the detection and treatment of dyspnea (defined as “breathing discomfort”). Methods Published information on the prevalence, mechanisms, and potential negative impacts of dyspnea in mechanically ventilated patients are reviewed. The most appropriate tools to detect and quantify dyspnea in ICU patients are also assessed. Results/Conclusions Growing evidence suggests that dyspnea is a frequent issue in mechanically ventilated ICU patients, is highly associated with anxiety and pain, and is improved in many patients by altering the ventilator settings. Conclusions Future studies are needed to better delineate the impact of dyspnea in the ICU and to define diagnostic, monitoring and therapeutic protocols.
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-013-3117-3