%0 Journal Article %A Laurence Dangers %A Claire Montlahuc %A Achille Kouatchet %A Samir Jaber %A Ferhat Meziani %A Sébastien Perbet %A Thomas Similowski %A Matthieu Resche-Rigon %A Elie Azoulay %A Alexandre Demoule %A , %A , %T Dyspnea in patients receiving noninvasive ventilation for acute respiratory failure: prevalence, risk factors and prognostic impact – a prospective observational study %D 2018 %R 10.1183/13993003.02637-2017 %J European Respiratory Journal %P 1702637 %X Dyspnea is a frequent and intense symptom in intubated patients, but little attention has been paid to dyspnea during noninvasive mechanical ventilation (NIV) in the intensive care unit (ICU).The objectives of this study were to quantify the prevalence, intensity and prognostic impact of dyspnea in patients receiving NIV for acute respiratory failure (ARF) based on secondary analysis of a prospective observational cohort study in patients who received ventilatory support for ARF in 54 ICUs in France and Belgium. Dyspnea was measured by a modified Borg scale.Among the 426 patients included, the median Dyspnea score was 4 [3–5] on admission and 3 [2–4] after the first NIV session (p=0.001). Dyspnea intensity ≥4 after the first NIV session was associated with SOFA (OR, 1.12; p=0.001), respiratory rate (OR, 1.03; p=0.032), anxiety (OR, 1.92; p=0.006), leaks (OR 2.5; p=0.002) and PaCO2 (OR, 0.98; p=0.025). Dyspnea intensity ≥4 was independently associated with NIV failure (OR, 2.41, p=0.001) and mortality (OR, 2.11; p=0.009), but not with higher post-ICU burden and altered quality of life.Dyspnea is frequent and intense in patients receiving NIV for ARF and is associated with a higher risk of NIV failure and poorer outcome.In patients who receive NIV in the intensive care unit, dyspnea is frequent and is associated with a poorer outcomeFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Samir Jaber reports personal fees from Fisher & Paykel, Dräger, Medtronic, Xenios, unrelated to the submitted work. Thomas Similowski reports personal fees from AstraZeneca, Boerhinger Ingelheim France, GSK, personal fees and non-financial support from Novartis, personal fees from Lungpacer Inc., TEVA, Chiesi, Pierre Fabre, Invacare, unrelated to the submitted work. In addition, Thomas Similowski has a patent for a “brain-ventilator interface to improve the detection of dyspnea” licensed to Air Liquide Medical Systems and MyBrainTechnology. Elie Azoulay reports grants from the French Ministry of Health, personal fees from Alexion, personal fees from MSD, grants and non-financial support from Pfizer, personal fees from Gilead, personal fees from Baxter, during conduct of the study. Alexandre Demoule reports grants from the French Ministry of Health, personal fees and non-financial support from Medtronic, grants, personal fees and non-financial support from Philips, grants and personal fees from Resmed and Fisher & Paykel, personal fees from Baxter and Hamilton, unrelated to the submitted work. Laurence Dangers, Claire Montlahuc, Achille Kouatchet, Ferhat Meziani, Sébastien Perbet and Matthieu Resche-Rigon have no conflict of interest.Conflict of interest: Dr. Dangers has nothing to disclose.Conflict of interest: Dr. MONTLAHUC has nothing to disclose.Conflict of interest: Dr. Kouatchet has nothing to disclose.Conflict of interest: Dr. JABER reports personal fees from FISHER PAIKEL, personal fees from DRAGER, personal fees from MEDTRONIC, personal fees from XENIOS, outside the submitted work; .Conflict of interest: Dr. Meziani has nothing to disclose.Conflict of interest: Dr. Perbet has nothing to disclose.Conflict of interest: Dr. SIMILOWSKI reports personal fees from AstraZeneca, personal fees from Boerhinger Ingelheim France, personal fees from GSK, personal fees and non-financial support from Novartis, personal fees from Lungpacer Inc. , personal fees from TEVA, personal fees from Chiesi, personal fees from Pierre Fabre, personal fees from Invacare, outside the submitted work; In addition, Dr. SIMILOWSKI has a patent about a “brain-ventilator interface to improve the detection of dyspnea” licensed to Air Liquide Medical Systems and MyBrainTechnology.Conflict of interest: Dr. RESCHE-RIGON has nothing to disclose.Conflict of interest: Dr. Azoulay reports grants from Ministry of Health, personal fees from Alexion, personal fees from MSD, grants and non-financial support from Pfizer, personal fees from Gilead, personal fees from Baxter, during the conduct of the study; .Conflict of interest: Dr. Demoule reports personal fees and non-financial support from Medtronic, grants, personal fees and non-financial support from Philips, grants and personal fees from Resmed, personal fees from Baxter, personal fees from Hamilton, grants and personal fees from Fisher & Paykel, grants from French Ministry of Health, outside the submitted work; . %U https://erj.ersjournals.com/content/erj/early/2018/05/24/13993003.02637-2017.full.pdf