Measurements of Dyspnea in Patients Treated with Mechanical Ventilation.

Powers, Jan; Bennett, Surussawadi

doi:10.1097/01823246-199910040-00007

Cited by 8 publications

(11 citation statements)

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“…This is a higher prevalence compared to the self-reported dyspnea of 44% in the ICU patients reported by Puntillo et al (3) and 33% in ICU cancer patients reported by Nelson et al (28). A recent review of studies of dyspnea in mechanically ventilated patients found that dyspnea is present in 11 to 50% of patients (4), except for one study where all five patients reported dyspnea (16). The relatively high prevalence of breathlessness in our study can be due to that our ratings of patients were done during a SBT, with no/low levels of pressure support, while other studies have obtained self-reports during stable ventilatory support (4).…”

Section: Discussioncontrasting

confidence: 64%

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Underestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial

Haugdahl

Storli

Meland

et al. 2015

Am J Respir Crit Care Med

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Section: Discussioncontrasting

confidence: 64%

“…Breathlessness was rated by a validated 11-point NRS (16,17) (see Graph E1 in the online supplement). The operational definition of perception of security and improvement of respiratory function were developed into two questions both rated by 11-point NRS ranging from 0 to 10.…”

Section: Assessmentsmentioning

confidence: 99%

Underestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial

Haugdahl

Storli

Meland

et al. 2015

Am J Respir Crit Care Med

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“…26 Dyspnoea was recorded both at rest (sitting comfortably in the chair or bed) and during exercise (the peak exercise activity experienced in the previous 24 hours) by research nurses blinded to group allocation.…”

Section: Secondary Endpointsmentioning

confidence: 99%

Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial

Bissett

Leditschke

Neeman

et al. 2016

Thorax

105

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BackgroundIn patients who have been mechanically ventilated, inspiratory muscles remain weak and fatigable following ventilatory weaning, which may contribute to dyspnoea and limited functional recovery. Inspiratory muscle training may improve inspiratory muscle strength and endurance following weaning, potentially improving dyspnoea and quality of life in this patient group.MethodsWe conducted a randomised trial with assessor-blinding and intention-to-treat analysis. Following 48 hours of successful weaning, 70 participants (mechanically ventilated ≥7 days) were randomised to receive inspiratory muscle training once daily 5 days/week for 2 weeks in addition to usual care, or usual care (control). Primary endpoints were inspiratory muscle strength and fatigue resistance index (FRI) 2 weeks following enrolment. Secondary endpoints included dyspnoea, physical function and quality of life, post-intensive care length of stay and in-hospital mortality.Results34 participants were randomly allocated to the training group and 36 to control. The training group demonstrated greater improvements in inspiratory strength (training: 17%, control: 6%, mean difference: 11%, p=0.02). There were no statistically significant differences in FRI (0.03 vs 0.02, p=0.81), physical function (0.25 vs 0.25, p=0.97) or dyspnoea (−0.5 vs 0.2, p=0.22). Improvement in quality of life was greater in the training group (14% vs 2%, mean difference 12%, p=0.03). In-hospital mortality was higher in the training group (4 vs 0, 12% vs 0%, p=0.051).ConclusionsInspiratory muscle training following successful weaning increases inspiratory muscle strength and quality of life, but we cannot confidently rule out an associated increased risk of in-hospital mortality.Trial registration numberACTRN12610001089022, results.

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“…Dyspnoea will be measured using a Modified Borg Scale (RPE categorical score out of 10), which has been found to have acceptable reliability and validity in patients undergoing MV 24. RPE will be recorded both at rest and during exercise at successful weaning (24 h) and 1 week postweaning (by a blinded assessor).…”

Section: Rct1: Overviewmentioning

confidence: 99%

Protocol: inspiratory muscle training for promoting recovery and outcomes in ventilated patients (IMPROVe): a randomised controlled trial

et al. 2012

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IntroductionInspiratory muscle weakness is a known consequence of mechanical ventilation and a potential contributor to difficulty in weaning from ventilatory support. Inspiratory muscle training (IMT) reduces the weaning period and increases the likelihood of successful weaning in some patients. However, it is not known how this training affects the residual inspiratory muscle fatigability following successful weaning nor patients' quality of life or functional outcomes.Methods and analysisThis dual centre study includes two concurrent randomised controlled trials of IMT in adult patients who are either currently ventilator-dependent (>7 days) (n=70) or have been recently weaned from mechanical ventilation (>7 days) in the past week (n=70). Subjects will be stable, alert and able to actively participate and provide consent. There will be concealed allocation to either treatment (IMT) or usual physiotherapy (including deep breathing exercises without a resistance device). Primary outcomes are inspiratory muscle fatigue resistance and maximum inspiratory pressures. Secondary outcomes are quality of life (Short Form-36v2, EQ-5D), functional status (Acute Care Index of Function), rate of perceived exertion (Borg Scale), intensive care length of stay (days), post intensive care length of stay (days), rate of reintubation (%) and duration of ventilation (days).Ethics and disseminationEthics approval has been obtained from relevant institutions, and results will be published with a view to influencing physiotherapy practice in the management of long-term ventilator-dependent patients to accelerate weaning and optimise rehabilitation outcomes.Trial registration numberACTRN12610001089022.

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Measurements of Dyspnea in Patients Treated with Mechanical Ventilation.

Cited by 8 publications

References 0 publications

Underestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial

Underestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial

Inspiratory muscle training to enhance recovery from mechanical ventilation: a randomised trial

Protocol: inspiratory muscle training for promoting recovery and outcomes in ventilated patients (IMPROVe): a randomised controlled trial

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