Abstract

Consultation-liaison (CL) psychiatrists frequently address dyspnea in intensive care unit (ICU) patients. Dyspnea is common in this patient population, but is frequently misunderstood and underappreciated in non-communicative ICU patients.This paper provides an updated review on dyspnea specifically in the ICU population, including its pathophysiology and management, pharmacological and non-pharmacological, aimed at CL psychiatrists consulting in ICU.A literature review was conducted with PubMed, querying published articles for topics associated with dyspnea and dyspnea-associated anxiety (DAA) in ICU patient populations. When literature in ICU populations was limited, information was deduced from dyspnea and anxiety management from non-ICU populations. Articles discussing the definition of dyspnea, mechanistic pathways, screening tools, and pharmacologic and non-pharmacologic management were included.A reference guide was created to help CL psychiatrists and intensivists in the screening and treatment of dyspnea and DAA in critically ill patients.Dyspnea is frequently associated with anxiety, prolonged days on mechanical ventilation, and worse quality of life after discharge. It can also increase the risk of posttraumatic stress disorder post ICU discharge. However, it is not routinely screened for, identified, or addressed in the ICU. This manuscript provides an updated review on dyspnea and DAA in the ICU population, including its pathophysiology and management, and offers a useful reference for CL psychiatrists to provide treatment recommendations.

View details for DOI 10.1016/j.jaclp.2023.11.001

View details for PubMedID 37952697