UMEM Educational Pearls

Title: Managing Dyspnea in the Intubated Patient

Posted: 1/1/2019 by Mike Winters, MD
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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)

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