title: Unrecognized suffering in the ICU: addressing dyspnea in mechanically ventilated patients.
abstract: BACKGROUND
  Intensive care unit (ICU) patients are exposed to many sources of discomfort. Although increasing attention is being given to the detection and treatment of pain, very little is given to the detection and treatment of dyspnea (defined as "breathing discomfort").
  
  
  METHODS
  Published information on the prevalence, mechanisms, and potential negative impacts of dyspnea in mechanically ventilated patients are reviewed. The most appropriate tools to detect and quantify dyspnea in ICU patients are also assessed.
  
  
  CONCLUSIONS
  Growing evidence suggests that dyspnea is a frequent issue in mechanically ventilated ICU patients, is highly associated with anxiety and pain, and is improved in many patients by altering the ventilator settings.
  
  
  CONCLUSIONS
  Future studies are needed to better delineate the impact of dyspnea in the ICU and to define diagnostic, monitoring and therapeutic protocols.
authors.affiliation: ER10, Université Paris 6-Pierre et Marie Curie, Paris, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Schmidt
authors.forename: Robert B
authors.initials: RB
authors.lastname: Banzett
authors.forename: Mathieu
authors.initials: M
authors.lastname: Raux
authors.forename: Capucine
authors.initials: C
authors.lastname: Morélot-Panzini
authors.forename: Laurence
authors.initials: L
authors.lastname: Dangers
authors.forename: Thomas
authors.initials: T
authors.lastname: Similowski
authors.forename: Alexandre
authors.initials: A
authors.lastname: Demoule
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D003422:Critical Care / Q000379:methods / Q000592:standards*; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D006801:Humans; D007362:Intensive Care Units; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods; D013990:Tidal Volume / Q000502:physiology; D064232:Visual Analog Scale