Common reasons for admission to an intensive care unit (ICU) are respiratory failure
that has produced dyspnea and respiratory distress, and the need for oxygen, ventilatory
support, and close monitoring. The provision of oxygen and ventilation reduces dyspnea,
although adding the burden of intubation and restraints, until the underlying condition
that produced hypoxemia or breathing failure is corrected. Some patients will decline
mechanical ventilation or have it withdrawn because of their pre-ICU prognosis or
the failure of ICU interventions to produce an outcome that is satisfactory to the
patient. Patients who forgo mechanical ventilation will require other strategies to
reduce dyspnea and respiratory distress, and they are vulnerable to underrecognition
and treatment of their symptom burden.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
Content published before 2002 is available via pay-per-view purchase only.
Subscribe:
Subscribe to Critical Care ClinicsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The evolution of asphyxial defense.Integr Physiol Behav Sci. 1993; 28: 317-330
- Symptom distress—the concept.Semin Oncol Nurs. 1987; 3: 242-247
- The dyspnea experience: nociceptive properties and a model for research and practice.Advances in Nursing Science. 1992; 15: 64-76
- Operationalizing dyspnea: focus on measurement.Heart Lung. 1992; 21: 167-179
Campbell M.L., Therrien B. Respiratory distress: a model of subcortical responses to an asphyxial threat in persons with declining or impaired cognition. J Nurs Scholarship, submitted
- Dyspnea during hospitalization for acute phase of illness as recalled by patients with chronic obstructive pulmonary disease.Heart Lung. 1990; 19: 186-191
- Psychophysiologic aspects of dyspnea in chronic obstructive pulmonary disease: a pilot study.Heart Lung. 1990; 19: 252-257
- Dyspnea, anxiety, and depression in chronic respiratory impairment.Gen Hosp Psychiatry. 1992; 14: 20-28
- Multidimensional analysis of the symptoms of chronic bronchitis and emphysema.J Behav Med. 1983; 6: 339-357
- Breathlessness in humans activates insular cortex.Neuroreport. 2000; 11: 2117-2120
- Evidence for limbic system activation duirng CO2-stimulated breathing in man.J Physiol. 1995; 488: 77-84
- Neuroimaging of cerebral activations and deactivations associated with hypercapnia and hunger for air.Proc Natl Acad Sci USA. 2001; 98: 2029-2034
- Bold fMRI identifies limbic, paralimbic, and cerebellar activation during air hunger.J Neurophysiol. 2002; 88: 1500-1511
- Topographic organization of respiratory responses to glutamate stimulation of the parabrachial nucleus in the rat.J Neurosci. 1994; 14: 6500-6510
- Regional brain activation in humans during respiratory and blood pressure challenges.Clin Exp Pharmacol Physiol. 1998; 25: 483-486
- Respiratory physiology: the essentials. Lippincott, Williams and Wilkins, Philadelphia1999
- Mechanisms of dyspnea.in: Mahler D.A Dyspnea. Marcel Decker, Inc, New York1998: 63-95
- Corollary discharges: motor commands and perception.in: Brookhart J.M Mountcastle V.B The nervous system: handbook of physiology. American Physiological Society, Bethseda (MD)1981: 1415-1447
- Dissociation between dyspnea and respiratory effort.Am Rev Respir Dis. 1992; 146: 1222-1225
- The effect of respiratory muscle fatigue on respiratory sensations.Clin Sci. 1981; 60: 463-466
- Effect of changes in inspiratory muscle strength on the sensation of respiratory force.J Appl Physiol. 1991; 70: 240-245
- Effect of increased lung volume on perception of breathlessness, effort, and tension.J Appl Physiol. 1984; 57: 686-691
- Breathlessness during exercise with and without resistive loading.J Appl Phsyiol. 1986; 61: 896-905
- Breathlessness during different forms of ventilatory stimulation: a study of mechanisms in normal subjects and respiratory patients.Clin Sci. 1985; 69: 663-672
- Effect of inspiratory flow on respiratory sensation and pattern of breathing.Am J Respir Crit Care Med. 1995; 151: 751-757
- The comfort of breathing: a study with volunteers assessing the influence of various modes of assisted ventilation.Crit Care Med. 2000; 28: 3645-3648
- Symptom control during the last week of life on a palliative care unit.J Palliat Care. 1991; 7: 5-11
- Common symptoms in patients with advanced cancer.J Palliat Care. 1991; 7: 25-29
- How much of a problem is dyspnea in advanced cancer?.Palliat Med. 1991; 5: 20-26
- Self-reported symptom experience of critically ill cancer patients receiving intensive care.Crit Care Med. 2001; 29: 277-282
- Dyspnea in cancer patients: prevalence and associated factors.J Pain Symptom Manage. 1999; 21: 95-102
- The frequency and correlates of dyspnea in patients with advanced cancer.J Pain Symptom Manage. 2000; 19: 357-362
- Dyspnea in terminally ill cancer patients.Chest. 1986; 89: 234-236
- Symptoms of lung cancer.Palliat Med. 1992; 6: 309-315
- Dying with lung cancer or chronic obstructive pulmonary disease: insights from SUPPORT.J Am Geriatr Soc. 2000; 48: S146-S153
- How well do surrogates assess the pain of seriously ill adults.Crit Care Med. 2000; 28: 1347-1352
- The last six months of life for patients with congestive heart failure.J Am Geriatr Soc. 2000; 48: S101-S109
- Dying from heart disease.J R Soc Phys. 1996; 30: 325-328
- Living and dying with chronic obstructive pulmonary disease.J Am Geriatr Soc. 2000; 48: S91-S100
- Palliative care in chronic obstructive airways disease.Palliat Med. 1998; 12: 245-254
- Mini-Mental State, a practical guide for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- The frequency and clinical course of cognitive impairment in patients with terminal cancer.Cancer. 1997; 79: 835-842
- Psychiatric morbidity in terminally ill cancer patients: a prospective study.Cancer. 1997; 78: 1131-1137
- Cognitive failure in patients with terminal cancer: a prospective study.J Pain Symptom Manage. 1992; 7: 192-195
- Evaluation of delirium in critically ill patients: validation of the confusion assessment method for the intensive care unit.Crit Care Med. 2001; 29: 1370-1379
- Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).JAMA. 2001; 286: 2703-2710
- The impact of delirium in the intensive care unit on hospital length of stay.Intensive Care Med. 2001; 27: 1892-1900
- Delirium in an intensive care unit: a study of risk factors.Intensive Care Med. 2001; 27: 1297-1304
- Clinical measurement of dyspnea.Dimens Crit Care Nurs. 1989; 8: 210-216
- Validity of the numeric rating scale as a measure of dyspnea.Am J Crit Care. 1998; 7: 200-204
- Validation of a vertical visual analogue scale as a measure of clinical dyspnea.Rehabil Nurs. 1989; 14: 323-325
- Management of pain in elderly patients with cancer.JAMA. 1998; 279: 1877-1882
- Pain evaluation and management in the nursing home.Ann Intern Med. 1995; 123: 681-687
- Correlates and management of nonmalignant pain in the nursing home.J Am Geriatr Soc. 1999; 47: 936-942
- Correlations between dyspnea, diaphragm and sternomastoid recruitment during inspiratory resistance breathing in normal subjects.Chest. 1990; 98: 298-302
- Psychologic and physiologic factors related to dyspnea in subjects with chronic obstructive pulmonary disease.Heart Lung. 1986; 15: 595-601
- Patient responses during rapid terminal weaning from mechanical ventilation: a prospective study.Crit Care Med. 1999; 27: 73-77
- Alae nasi activation and nasal resistance in healthy subjects.J Appl Physiol. 1982; 52: 1432-1437
- Deep breathing in children with severe malaria: indicator of metabolic acidosis and poor outcome.Am J Trop Med Hyg. 1996; 55: 521-524
- Relationship between clinical signs and lung function in horses with recurrent airway obstruction during a bronchodilator trial.Equine Vet J. 2000; 32: 393-400
- Caring for dying patients who have air hunger.J Nurs Scholarship. 2000; 32: 137-143
- Risk factors for mortality among children hospitalized because of acute respiratory infections in Bangui, Central African Republic.Pediatr Infect Dis J. 2000; 19: 424-432
- Restlessness of respiration as a manifestation of akathisia: five case reports of akathisia.J Clin Psychiatry. 2000; 61: 737-741
- Death in the hospital.Arch Intern Med. 1998; 158: 1570-1572
- The last 48 hours of life.J Palliat Care. 1990; 6: 7-15
- Chronic obstructive lung disease: postural relief of dyspnea.Arch Phys Med Rehabil. 1974; 55: 494-504
- Postural relief of dyspnea in severe chronic obstructive lung disease.Am Rev Respir Dis. 1980; 122: 201-211
- Symptomatic benefit of supplemental oxygen in hypoxemic patients with terminal cancer: the use of N of 1 randomized control trial.J Pain Symptom Manage. 1992; 7: 365-368
- Effects of oxygen on dyspnoea in hypoxaemic terminal-cancer patients.Lancet. 1993; 342: 13-14
- Symptomatic benefit of supplemental oxygen in hypoxemic patients with chronic lung disease.Am Rev Respir Dis. 1991; 143: 913-915
- Does oxygen help dyspnea in patients with cancer?.Am J Respir Crit Care Med. 1996; 153: 1515-1518
- Reducing ventilatory response to carbon dioxide by breathing cold air.Am Rev Respir Dis. 1984; 129: 687-690
- Effects of nasal cold receptors on pattern of breathing.J Appl Physiol. 1988; 64: 371-376
- The effect of nasal flow on breathlessness in patients with chronic obstructive pulmonary disease.Am Rev Respir Dis. 1988; 137: 1285-1288
- Cold facial stimulation reduces breathlessness induced in normal subjects.Am Rev Respir Dis. 1987; 136: 58-61
- A systematic review of the use of opioids in the management of dyspnoea.Thorax. 2002; 57: 922-923
- Control of dyspnea in advanced cancer patients.Chest. 1990; 98: 1544-1545
- Effect of 30mg of morphine alone or wit promethazine or prochlorperazine on the exercise capacity of patients with COPD.Chest. 1996; 109: 975-981
- Procedures used in withdrawal of mechanical ventilation.Am J Crit Care. 1995; 5: 331-338
- Ordering and administration of sedatives and analgesics during the withholding and withdrawal of life support from critically ill patients.JAMA. 1992; 267: 949-953
- Principles of biomedical ethics. 4th edition. Oxford University Press, New York1994
- Deciding to forego life-sustaining treatment. US Government Printing Office, Washington (DC)1983
- Guidelines on the termination of life-sustaining treatment and the care of the dying. Indiana University Press, Bloomington (IN)1987
- Total sedation in end-of-life care: clinical considerations.J Hospice Palliat Nurs. 2001; 3: 81-87
- Recommendations for end-of-life care in the intensive care unit: the ethics committee of the Society of Critical Care Medicine.Crit Care Med. 2001; 29: 2332-2348
- The Supreme Court speaks—not assisted suicide but a constitutional right to palliative care.N Engl J Med. 1997; 337: 1234-1236
- Total sedation educational resources. National Hospice and Palliative Care Organization, Alexandria (VA)2001
- Palliative sedation at the end of life.J Hospice Palliat Nurs. 2003; 5: 235-238
- Palliation of respiratory symptoms.in: Doyle D Hanks G.W.C MacDonald N Oxford textbook of palliative medicine. Oxford University Press, Oxford (England)1993: 349-378
Article info
Identification
Copyright
© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
