Impact of Dyspnea on Patients in the Intensive Care Unit

Study Overview
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Brief Summary
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Although pain has been extensively studied in ICU patients, only a few studies have focused on dyspnea, which is experienced by 50% of mechanically ventilated patients. The purpose of the present study is to determine whether dyspnea in intensive care unit patients is associated with a higher length of stay in the ICU and a higher incidence of post traumatic stress disorders.

Detailed Description
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Intensive care unit (ICU) patients are continuously exposed to various unpleasant sensations that are as many sources of discomfort. If, growing attention has been given to the detection and treatment of pain, very little attention has been given to dyspnea. However, there is growing evidence suggesting that dyspnea is frequent and severe in mechanically ventilated ICU patients. In mechanically ventilated ICU patients, dyspnea is independently associated with anxiety and mechanical ventilation itself. Indeed, an optimization of ventilator settings alleviates dyspnea in 35% of patients. Various arguments suggest that dyspnea contributes to the dark experience of ICU and participates to the genesis of post traumatic stress disorders. In addition, dyspnea is associated with a longer duration of mechanical ventilation. Large multicentre studies are however lacking. The aims of the present multicentre study are 1) to quantify the prevalence of dyspnea in a large population of ICU mechanically ventilated patients, 2) to examine the link between the level of dyspnea and the occurrence of adverse events in the ICU, 3) to determine whether dyspnea in intensive care unit patients is associated with a higher length of stay in the ICU and a higher incidence of post traumatic stress disorder associated symptoms.

Official Title
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Impact of DYSpnea on the ouTcome of Patients Admitted for an Acute RESpiratory Failure in the intenSive Care Unit

Conditions
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Dyspnea

Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Invasive mechanical ventilation in the ICU for > 24 hours Remaining stay in the ICU estimated > 24 hours Exclusion criteria : RASS <-2 or >+2 Delirium (defined according to CAM-ICU) Severe cognitive impairment or severe psychiatric disease Patient who does not understand French Severe depthless Age <18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ICU length of stay |  | 3 months | 
| incidence of post traumatic stress disorders |  | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Anxiety and depression (Hamilton anxiety and depression scale) | Hamilton anxiety and depression scale | 3 months | 
| Quality of life (Short-Form 36) | Short-Form 36 | 3 months | 
| Pain (Visual Analogic Scale) | Visual Analogic Scale | 3 months | 
| Quality of Sleep (Pittsburgh Scale) | Pittsburgh Scale | 3 months |