Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 1;53(6):e1282-e1291.
doi: 10.1097/CCM.0000000000006664. Epub 2025 Apr 14.

Dyspnea Among Mechanically Ventilated Patients: A Systematic Review

Kira A Grush  1 , Ellie Svoboda  2 , Peter J Dunbar  3 , Arun Kannappan  3 , Jenna Perrodin  4 , Michael Z Root  3 , Mark E Mikkelsen  3
Affiliations

Dyspnea Among Mechanically Ventilated Patients: A Systematic Review

Kira A Grush et al. Crit Care Med. .

Abstract

Objectives: Dyspnea is a common and distressing symptom; yet, how frequently and intensely mechanically ventilated patients experience dyspnea remains unclear. We performed a systematic review to identify the prevalence and severity of dyspnea in communicative, mechanically ventilated critically ill adults. We also identified factors associated with dyspnea in the short-term and long-term and potential management strategies.

Data sources: We performed a systematic search of the following databases: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, PsycInfo, and CINAHL.

Data extraction: Our search strategy used variations of these terms: dyspnea, mechanical ventilation, and critical care. We included prospective observational studies and randomized controlled trials. Two independent reviewers screened citations and extracted data using a predrafted report form to examine dyspnea prevalence and severity, association with short-term and long-term outcomes, and interventions to mitigate dyspnea.

Data synthesis: Of 6290 records screened, we included 21 observational studies and 3 randomized controlled trials. We calculated percentages and 95% CIs for prevalence using Stata 17 se . Dyspnea was present in 475 of 1169 communicative, mechanically ventilated patients (40.6%, 95% CI, 37.8-43.5) and was found to be moderate to severe. In the lone study to examine long-term outcomes, dyspnea was associated with posttraumatic stress disorder (PTSD) at 90 days. Interventions to reduce dyspnea included: mechanical threshold inspiratory muscle training, ventilation adjustments, supplemental high-flow nasal cannula, opioids, hyperoxemia, and nonpharmacologic interventions, including music and fan therapy.

Conclusions: In this systematic review, we found that dyspnea among mechanically ventilated patients is common and moderate to severe in its intensity. Dyspnea is associated with adverse long-term outcomes, including probable PTSD. Strategies to manage, or palliate, dyspnea were identified. Future study is warranted to examine how this information can be incorporated into clinical practice to improve short-term and long-term outcomes.

Keywords: critical care; dyspnea; mechanical ventilation; prevalence; systematic review.

PubMed Disclaimer

Conflict of interest statement

Dr. Root received funding from the University of Colorado Institute for Healthcare Quality, Safety, and Efficiency Clinical Effectiveness and Patient Safety. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

    1. Demoule A, Decavèle M, Antonelli M, et al.: Dyspnoea in acutely ill mechanically ventilated adult patients: An ERS/ESICM statement. Intensive Care Med. 2024; 50:159–180
    1. Parshall MB, Schwartzstein RM, Adams L, et al.; American Thoracic Society Committee on Dyspnea: An official American Thoracic Society statement: Update on the mechanisms, assessment, and management of dyspnea. Am J Respir Crit Care Med. 2012; 185:435–452
    1. Stevens JP, Dechen T, Schwartzstein RM, et al.: Association of dyspnoea, mortality and resource use in hospitalized patients. Eur Respir J. 2021; 58:1902107
    1. Schmidt M, Demoule A, Polito A, et al.: Dyspnea in mechanically ventilated critically ill patients. Crit Care Med. 2011; 39:2059–2065
    1. Demoule A, Hajage D, Messika J, et al.; REVA Network (Research Network in Mechanical Ventilation): Prevalence, intensity, and clinical impact of dyspnea in critically ill patients receiving invasive ventilation. Am J Respir Crit Care Med. 2022; 205:917–926

Publication types