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Published in: Intensive Care Medicine 2/2024

22-02-2024 | Dyspnea | Conference Reports and Expert Panel

Dyspnoea in acutely ill mechanically ventilated adult patients: an ERS/ESICM statement

Authors: Alexandre Demoule, Maxens Decavele, Massimo Antonelli, Luigi Camporota, Fekri Abroug, Dan Adler, Elie Azoulay, Metin Basoglu, Margaret Campbell, Giacomo Grasselli, Margaret Herridge, Miriam J. Johnson, Lionel Naccache, Paolo Navalesi, Paolo Pelosi, Richard Schwartzstein, Clare Williams, Wolfram Windisch, Leo Heunks, Thomas Similowski

Published in: Intensive Care Medicine | Issue 2/2024

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Abstract

This statement outlines a review of the literature and current practice concerning the prevalence, clinical significance, diagnosis and management of dyspnoea in critically ill, mechanically ventilated adult patients. It covers the definition, pathophysiology, epidemiology, short- and middle-term impact, detection and quantification, and prevention and treatment of dyspnoea. It represents a collaboration of the European Respiratory Society (ERS) and the European Society of Intensive Care Medicine (ESICM). Dyspnoea ranks among the most distressing experiences that human beings can endure. Approximately 40% of patients undergoing invasive mechanical ventilation in the intensive care unit (ICU) report dyspnoea, with an average intensity of 45 mm on a visual analogue scale from 0 to 100 mm. Although it shares many similarities with pain, dyspnoea can be far worse than pain in that it summons a primal fear response. As such, it merits universal and specific consideration. Dyspnoea must be identified, prevented and relieved in every patient. In the ICU, mechanically ventilated patients are at high risk of experiencing breathing difficulties because of their physiological status and, in some instances, because of mechanical ventilation itself. At the same time, mechanically ventilated patients have barriers to signalling their distress. Addressing this major clinical challenge mandates teaching and training, and involves ICU caregivers and patients. This is even more important because, as opposed to pain which has become a universal healthcare concern, very little attention has been paid to the identification and management of respiratory suffering in mechanically ventilated ICU patients.
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Metadata
Title
Dyspnoea in acutely ill mechanically ventilated adult patients: an ERS/ESICM statement
Authors
Alexandre Demoule
Maxens Decavele
Massimo Antonelli
Luigi Camporota
Fekri Abroug
Dan Adler
Elie Azoulay
Metin Basoglu
Margaret Campbell
Giacomo Grasselli
Margaret Herridge
Miriam J. Johnson
Lionel Naccache
Paolo Navalesi
Paolo Pelosi
Richard Schwartzstein
Clare Williams
Wolfram Windisch
Leo Heunks
Thomas Similowski
Publication date
22-02-2024
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2024
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-023-07246-x

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