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Relationship between dyspnoea and respiratory drive in mechanically ventilated patients: A prospective observational
Chie Hatozaki1, Hideaki Sakuramoto2, Gen Aikawa3
1Intensive Care Unit, University of Tsukuba Hospital, Tsukuba, Japan.
Background:
Patients with high respiratory drive during mechanical ventilation (MV) may be at risk for ventilator-induced lung injury, making control crucial. While high respiratory drive is often associated with dyspnoea, the relationship remains unclear.
Objectives:
We examined the relationship between three dyspnoea-rating scales and respiratory drive, as measured by airway occlusion pressure (P0.1), in patients receiving MV.
Methods:
A prospective observational study was conducted in the intensive care unit between February 2020 and March 2022. Adults (aged ≥20 years) expected to require MV for over 24 h were included. Dyspnoea was assessed using the Respiratory Distress Observation Scale, Intensive Care-Respiratory Distress Observation Scale, and Mechanical Ventilation-Respiratory Distress Observation Scale. Respiratory drive was measured using P0.1. Measurements were taken at up to two time points between intensive care unit admission and day 4 by two independent investigators blinded to each other's data. Pearson's correlation coefficients were used to assess relationships between dyspnoea scales and P0.1.
Results:
Of the 253 eligible patients, 131 were included, and 69 underwent P0.1 measurement. A total of 105 observation points were analysed. Weak negative correlations were found between the Respiratory Distress Observation Scale, Intensive Care-Respiratory Distress Observation Scale, and Mechanical Ventilation-Respiratory Distress Observation Scale and P0.1 (r = -0.293, p = 0.003; r = -0.240, p = 0.014; and r = -0.260, p = 0.008, respectively). Stratified analysis by baseline disease, severity, and sedation showed weak negative correlations only in the deep sedation group (r = -0.347, p = 0.020; r = -0.325, p = 0.029; and r = -0.352, p = 0.018, respectively), stronger than in the overall cohort. No significant correlations were found among groups stratified by disease or severity.
Conclusions:
In patients with MV, weak negative correlations were observed between dyspnoea assessed with the three scales and respiratory drive measured by P0.1.
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