CAUSES AND MANAGEMENT OF DYSPNEA

Introduction: Dyspnea is considered a very subjective clinical symptom of breathing difficulty and discomfort that typically consists of qualitatively distinct sensations that differ in strength and can only be recognized by the patient’s complaint. Dyspnea is similar to suffocation and is one of the most difficult symptoms experienced by critically ill patients, including those on mechanical ventilation. When a patient cannot report dyspnea, as typifies many critically ill patients, the observed behaviors are characterized as respiratory distress. Expert guidelines can help in the management of dyspnea, however additional empirical evidence to support clinical care is required, and wide variation does exist in clinical practice. The aim of this paper is to address the following questions: (1) How prevalent, intense, and distressing is dyspnea experienced by critically ill patients? (2) How should dyspnea be assessed in the intensive care unit (ICU)? (3) What are current strategies for managing dyspnea during critical illness? Aim of work: In this review, we will discuss dyspnea. Methodology: We did a systematic search for management of dyspnea using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: Alleviation of respiratory distress is a critical element of care in the ICU. A major goal for ICU care improvement is to not only enhance patient comfort, but to support other favorable outcomes of intensive care that are associated with dyspnea control. Selection of dyspnea assessment techniques to meet the specific communication capabilities of the patient is necessary to gain as much knowledge of what the patient is experiencing as possible. Selection of dyspnea management methods appropriate to the source, or anticipated source, of the symptom, the condition of the patient, and the goals of care requires the concerted efforts of a dedicated team of multidisciplinary health care professionals. Key words: dyspnea, presentation, causes, management, primary care