{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:42:02Z","timestamp":1791758522261,"version":"4.3.4"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["R01 NR16055"],"award-info":[{"award-number":["R01 NR16055"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIH","award":["R01 NR16055"],"award-info":[{"award-number":["R01 NR16055"]}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>No systematic investigation into dyspnea in patients receiving prolonged ventilation (&amp;gt;21 d) after recovering from critical illness has been published.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to determine the magnitude, nature, and pathophysiological basis of dyspnea during an unassisted-breathing trial in patients receiving prolonged ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Dyspnea intensity and descriptor selection were investigated in 27 patients receiving prolonged ventilation during a 60-minute unassisted-breathing trial. Pressure\u2013time product, respiratory mechanics, and PtcCO2 were also measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Of 10 patients who reported dyspnea during assist-control ventilation, 9 (90.0%) selected \u201cNot getting enough air\u201d to characterize dyspnea. Vt setting was lower in dyspneic than in nondyspneic patients (480.0 vs. 559.4 ml), P\u2009&amp;lt;\u20090.046. During the unassisted-breathing trial (n\u2009=\u200926), patients developed increases in dyspnea (P\u2009&amp;lt;\u20090.01) and PtcCO2 (P\u2009&amp;lt;\u20090.01) but no change in V\u0307e. Dyspnea score was strongly linked to PtcCO2 (P\u2009&amp;lt;\u20090.012) and airway resistance (P\u2009&amp;lt;\u20090.013) but not respiratory work (although pressure\u2013time product was almost three times higher than normal). At 60 minutes into the trial, 83.3% of patients selected \u201cNot getting enough air\u201d on its own or in combination with \u201cToo much effort\u201d to describe discomfort, whereas only 16.7% selected \u201cToo much effort\u201d on its own (P\u2009&amp;lt;\u20090.001). Across the dyspnea spectrum, patients chose \u201cNot getting enough air\u201d overwhelmingly over other descriptor options (P\u2009&amp;lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients developed increases in dyspnea and PtcCO2 but unchanged V\u0307e and work of breathing during an unassisted-breathing trial; patients selected air-hunger descriptors overwhelmingly over excessive effort. The observations support the belief that air hunger results from heightened respiratory center stimulation combined with the incapacity to increase V\u0307e.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202406-1243oc","type":"journal-article","created":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T17:06:21Z","timestamp":1734368781000},"page":"323-330","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":15,"title":["Air Hunger Far Exceeds Dyspnea Sense of Effort during Mechanical Ventilation and a Weaning Trial"],"prefix":"10.1093","volume":"211","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8762-3125","authenticated-orcid":false,"given":"Amal","family":"Jubran","sequence":"first","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital, Hines, Illinois"},{"name":"Stritch School of Medicine, Loyola University of Chicago, Maywood, Illinois"},{"name":"RML Specialty Hospital, Hinsdale, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Laghi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Hines Veterans Affairs Hospital, Hines, Illinois"},{"name":"Stritch School of Medicine, Loyola University of Chicago, Maywood, Illinois"},{"name":"RML Specialty Hospital, Hinsdale, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brydon J. 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