• 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, and Thomas Similowski.
• Service de Médecine Intensive-Réanimation, Département R3S, AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, 75013, Paris, France. alexandre.demoule@aphp.fr.
• Intensive Care Med. 2024 Feb 1; 50 (2): 159180159-180.

AbstractThis 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.© 2024. The authors 2024. For reproduction rights and permissions contact permissions@ersnet.org License: https://www.ersjournals.com/user-licence.

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