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Dyspnea Among Mechanically Ventilated Patients: A Systematic Review
Kira A Grush1, Ellie Svoboda2, Peter J Dunbar3
1University of Colorado Internal Medicine Residency Program, Department of Medicine, University of Colorado, Aurora, CO.
Critical Care Medicine
|April 14, 2025
Summary
Mechanically ventilated patients frequently experience moderate to severe dyspnea. This symptom is linked to long-term issues like PTSD, but management strategies exist.
Area of Science:
- Critical Care Medicine
- Respiratory Medicine
- Patient Experience
Background:
- Dyspnea is a distressing symptom in critically ill patients.
- The prevalence and severity of dyspnea in mechanically ventilated patients are not well understood.
- Understanding dyspnea is crucial for improving patient outcomes.
Purpose of the Study:
- To systematically review the prevalence and severity of dyspnea in communicative, mechanically ventilated adults.
- To identify factors associated with dyspnea in the short-term and long-term.
- To explore potential management strategies for dyspnea.
Main Methods:
- Systematic search of multiple medical databases (MEDLINE, Embase, etc.).
- Inclusion of prospective observational studies and randomized controlled trials.
- Data extraction on dyspnea prevalence, severity, associated outcomes, and interventions by two independent reviewers.
Main Results:
- Dyspnea affects 40.6% of communicative, mechanically ventilated patients and is moderate to severe.
- Dyspnea is associated with adverse long-term outcomes, including posttraumatic stress disorder (PTSD).
- Identified interventions include inspiratory muscle training, ventilation adjustments, high-flow nasal cannula, opioids, and nonpharmacologic methods.
Conclusions:
- Dyspnea is a common and severe symptom in mechanically ventilated patients.
- Dyspnea is linked to negative long-term consequences such as PTSD.
- Various strategies can manage or palliate dyspnea, warranting further clinical integration.
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