Dyspnea in the Intubated Patient

• Dyspnea may occur in up to 50% of intubated patients and has been associated with prolonged mechanical ventilation.
• A number of assessment tools are available to detect dyspnea in the intubated patient.
• Regardless of the tool used, once dyspnea is diagnosed, consider the following;
  • When possible, reduce nonrespiratory stimuli of the respiratory drive (i.e., fever, acidosis, anemia)
  • Minimize respiratory impedance (i.e., bronchodilators, thoracentesis for pleural effusion)
  • Optimize ventilator settings (i.e., change modes if applicable, increase inspiratory flow, increase PEEP)
  • Pharmacologic treatment (i.e., opioids, benzodiazepines)

References

Decavele M, et al. Detection and management of dyspnea in mechanically ventilated patients. Curr Opin Crit Care. 2019; 25:86-94.