Observation scales to suspect dyspnea in non-communicative intensive care unit patients

Excerpt

Dyspnea, like pain, is a major cause of physical suffering and emotional distress. In the intensive care unit, mechanically ventilated patients are at high risk of dyspnea [1], and increasing attention is being given to this symptom [1, 2]. Because its evaluation relies on self-report and self-assessment [3], dyspnea carries the risk of being underestimated or even unrecognized and therefore unattended in many intensive care unit patients. This is particularly so in patients unable to communicate with their caregivers (sedation, delirium, etc.). We have recently developed and validated a specific intensive care unit version of the respiratory distress observation scale (IC-RDOS, http://​www.​ic-rdos.​com) [4]. IC-RDOS, based on respiratory and behavioral signs, correlates strongly with ratings of dyspnea on a visual analogic scale in “communicative” patients, but this is by definition not the most pertinent target population. The present secondary analysis describes IC-RDOS in “non-communicative” intensive care unit patients, as the first step of its clinical and prognostic evaluation in this setting. …