Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study

Abstract : Dyspnea is a frequent and intense symptom in intubated patients, but little attention has been paid to dyspnea during noninvasive mechanical ventilation (NIV) in the intensive care unit (ICU).The objectives of this study were to quantify the prevalence, intensity and prognostic impact of dyspnea in patients receiving NIV for acute respiratory failure (ARF) based on secondary analysis of a prospective observational cohort study in patients who received ventilatory support for ARF in 54 ICUs in France and Belgium. Dyspnea was measured by a modified Borg scale.Among the 426 patients included, the median Dyspnea score was 4 [3-5] on admission and 3 [2-4] after the first NIV session (p=0.001). Dyspnea intensity ≥4 after the first NIV session was associated with SOFA (OR, 1.12; p=0.001), respiratory rate (OR, 1.03; p=0.032), anxiety (OR, 1.92; p=0.006), leaks (OR 2.5; p=0.002) and PaCO2 (OR, 0.98; p=0.025). Dyspnea intensity ≥4 was independently associated with NIV failure (OR, 2.41, p=0.001) and mortality (OR, 2.11; p=0.009), but not with higher post-ICU burden and altered quality of life.Dyspnea is frequent and intense in patients receiving NIV for ARF and is associated with a higher risk of NIV failure and poorer outcome.
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https://hal.umontpellier.fr/hal-01832378
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Soumis le : jeudi 9 janvier 2020 - 10:04:58
Dernière modification le : jeudi 27 février 2020 - 16:26:02

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Laurence Dangers, Claire Montlahuc, Achille Kouatchet, Samir Jaber, Ferhat Meziani, et al.. Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study. European Respiratory Journal, European Respiratory Society, 2018, ⟨10.1183/13993003.02637-2017⟩. ⟨hal-01832378⟩

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