Interventions Relieving Dyspnea in Intubated Patients Show Responsiveness of the Mechanical Ventilation–Respiratory Distress Observation Scale

• DOI: 10.1164/rccm.202301-0188oc
• Publication Date: 2023-03-28T01:21:45Z
• Authors: Maxens Decavèle; Côme Bureau; Sébastien Campion; Marie-Cécile Nierat; Isabelle Rivals; Nicolas Wattiez; Morgane Faure; Julien Mayaux; Elise Morawiec; Mathieu Raux; Thomas Similowski; Alexandre Demoule
• Keywords: Interquartile range; Parasternal line; Tachypnea

Rationale: Breathing difficulties are highly stressful. In critically ill patients, they associated with an increased risk of posttraumatic manifestations. Dyspnea, the corresponding symptom, cannot be directly assessed in noncommunicative patients. This difficulty can circumvented using observation scales such as mechanical ventilation-respiratory distress scale (MV-RDOS). Objective: To investigate performance and responsiveness MV-RDOS to infer dyspnea intubated Methods: Communicative patients exhibiting breathing under ventilation were prospectively included a visual analog scale, MV-RDOS, EMG activity alae nasi parasternal intercostals, EEG signatures respiratory-related cortical activation (preinspiratory potentials). Inspiratory-muscle preinspiratory activities surrogates dyspnea. Assessments conducted at baseline, after adjustment ventilator settings, and, some cases, morphine administration. Measurements Main Results: Fifty (age, 67 [(interquartile interval [IQR]), 61-76] yr; Simplified Acute Physiology Score II, 52 [IQR, 35-62]) included, 25 whom noncommunicative. Relief occurred (50%) adjustments 21 additional score decreased from 5.5 (IQR, 4.2-6.6) baseline 4.2 2.1-4.7; P < 0.001) 2.5 2.1-4.2; = 0.024) nasi/parasternal positively correlated (ρ 0.41 0.37, respectively). scores higher potentials (4.9 4.2-6.3] vs. 4.0 2.1-4.9]; 0.002). Conclusions: The seems able detect monitor respiratory symptoms reasonably well Clinical trial registered www.clinicaltrials.gov (NCT02801838).