{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T23:09:40Z","timestamp":1793920180684,"version":"4.8.0"},"reference-count":50,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T00:00:00Z","timestamp":1615852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann. Intensive Care"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Flexible fiberoptic bronchoscopy is frequently used in intensive care unit, but is a source of discomfort, dyspnea and anxiety for patients. Our objective was to assess the feasibility and tolerance of a sedation using remifentanil target-controlled infusion, to perform fiberoptic bronchoscopy in awake ICU patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials, patients and methods<\/jats:title>\n                    <jats:p>This monocentric, prospective observational study was conducted in awake patients requiring fiberoptic bronchoscopy. In accordance with usual practices in our center, remifentanil target-controlled infusion was used under close monitoring and adapted to the patient\u2019s reactions. The primary objective was the rate of successful procedures without additional analgesia or anesthesia. The secondary objectives were clinical tolerance and the comfort of patients (graded from \u201cvery uncomfortable\u201d to \u201cvery comfortable\u201d) and operators (numeric scale from 0 to 10) during the procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From May 2014 to December 2015, 72 patients were included. Most of them (69%) were hypoxemic and admitted for acute respiratory failure. No additional medication was needed in 96% of the patients. No severe side-effects occurred. Seventy-eight percent of patients described the procedure as \u201ccomfortable or very comfortable\u201d. Physicians rated their comfort with a median [IQR] score of 9 [8\u201310].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Remifentanil target-controlled infusion administered to perform awake fiberoptic bronchoscopy in critically ill patients is feasible without requirement of additional analgesics or sedative drugs. Clinical tolerance as well as patients\u2019 and operators\u2019 comfort were good to excellent. This technique could benefit patients\u2019 experience.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13613-021-00832-6","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T08:33:54Z","timestamp":1617957234000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Pain and dyspnea control during awake fiberoptic bronchoscopy in critically ill patients: safety and efficacy of remifentanil target-controlled infusion"],"prefix":"10.1016","volume":"11","author":[{"given":"Margot","family":"Caron","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Parrot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Elabbadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Dupeyrat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Turpin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Baury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacha","family":"Rozencwajg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarisse","family":"Blayau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Pierre","family":"Fulgencio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Gibelin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Yves","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9verine","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisy","family":"Daign\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-C\u00e9cile","family":"Allain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muriel","family":"Fartoukh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4373-0711","authenticated-orcid":false,"given":"T\u00e0i","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","published-online":{"date-parts":[[2021,3,16]]},"reference":[{"key":"832_CR1","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1097\/01.CCM.0000108875.35298.D2","volume":"32","author":"KA Puntillo","year":"2004","unstructured":"Puntillo KA, Morris AB, Thompson CL, Stanik-Hutt J, White CA, Wild LR. Pain behaviors observed during six common procedures: results from Thunder Project II*: Critical Care Medicine. 2004;32:421\u20137.","journal-title":"Crit Care Med"},{"issue":"1","key":"832_CR2","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1164\/rccm.201306-1174OC","volume":"89","author":"KA Puntillo","year":"2014","unstructured":"Puntillo KA, Max A, Timsit J-F, Vignoud L, Chanques G, Robleda G, et al. Determinants of procedural pain intensity in the intensive care unit: the Europain study. Am J Respir Crit Care Med. 2014;89(1):39-47.","journal-title":"Am J Respir Crit Care Med"},{"key":"832_CR3","first-page":"335","volume":"20","author":"F Barl\u00e9si","year":"2003","unstructured":"Barl\u00e9si F, Dissard-Barriol E, Gimenez C, Doddoli C, Greillier L. Kleisbauer J-P. Tolerance of fiberoptic bronchoscopy by self-administered questionnaire: in the words of the patients. Rev Mal Respir. 2003;20:335\u201340.","journal-title":"Rev Mal Respir"},{"key":"832_CR4","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.1378\/chest.114.5.1446","volume":"114","author":"GB Diette","year":"1998","unstructured":"Diette GB, White P, Terry P, Jenckes M, Wise RA, Rubin HR. Quality assessment through patient self-report of symptoms prefiberoptic and postfiberoptic bronchoscopy. Chest. 1998;114:1446\u201353.","journal-title":"Chest"},{"key":"832_CR5","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/0304-3959(79)90175-1","volume":"6","author":"H Merskey","year":"1979","unstructured":"Merskey H. Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain. 1979;6:249.","journal-title":"Pain"},{"key":"832_CR6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1111\/j.1365-2125.1974.tb00211.x","volume":"1","author":"EC Huskisson","year":"1974","unstructured":"Huskisson EC. Catecholamine excretion and pain. Br J Clin Pharmacol. 1974;1:80\u20132.","journal-title":"Br J Clin Pharmacol"},{"key":"832_CR7","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1016\/j.pain.2012.01.030","volume":"153","author":"W J\u00e4nig","year":"2012","unstructured":"J\u00e4nig W. Autonomic reactions in pain. Pain. 2012;153:733\u20135.","journal-title":"Pain"},{"key":"832_CR8","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1097\/00000539-200110000-00010","volume":"93","author":"WS Beattie","year":"2001","unstructured":"Beattie WS, Badner NH, Choi P. Epidural analgesia reduces postoperative myocardial infarction: a meta-analysis. Anesth Analg. 2001;93:853\u20138.","journal-title":"Anesth Analg"},{"key":"832_CR9","doi-asserted-by":"publisher","first-page":"S136","DOI":"10.1097\/CCM.0b013e3182a24105","volume":"41","author":"JE Davidson","year":"2013","unstructured":"Davidson JE, Harvey MA, Bemis-Dougherty A, Smith JM, Hopkins RO. Implementation of the pain, agitation, and delirium clinical practice guidelines and promoting patient mobility to prevent post-intensive care syndrome. Crit Care Med. 2013;41:S136\u201345.","journal-title":"Crit Care Med"},{"key":"832_CR10","doi-asserted-by":"publisher","first-page":"R14","DOI":"10.1186\/cc8870","volume":"14","author":"H Myhren","year":"2010","unstructured":"Myhren H, Ekeberg O, Toien K, Karlsson S, Stokland O. Posttraumatic stress, anxiety and depression symptoms in patients during the first year post intensive care unit discharge. Crit Care. 2010;14:R14.","journal-title":"Crit Care"},{"key":"832_CR11","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1007\/s001340051091","volume":"25","author":"MA Novaes","year":"1999","unstructured":"Novaes MA, Knobel E, Bork AM, Pav\u00e3o OF, Nogueira-Martins LA, Ferraz MB. Stressors in ICU: perception of the patient, relatives and health care team. Intensive Care Med. 1999;25:1421\u20136.","journal-title":"Intensive Care Med"},{"key":"832_CR12","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1097\/ALN.0b013e3181c0d4f0","volume":"111","author":"J-F Payen","year":"2009","unstructured":"Payen J-F, Bosson J-L, Chanques G, Mantz J, Labarere J. Pain assessment is associated with decreased duration of mechanical ventilation in the intensive care unit. Anesthesiology. 2009;111:1308\u201316.","journal-title":"Anesthesiology"},{"key":"832_CR13","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1097\/AJP.0b013e31806a23fb","volume":"23","author":"C G\u00e9linas","year":"2007","unstructured":"G\u00e9linas C, Johnston C. Pain assessment in the critically ill ventilated adult: validation of the Critical-Care Pain Observation Tool and physiologic indicators. Clin J Pain. 2007;23:497\u2013505.","journal-title":"Clin J Pain"},{"key":"832_CR14","doi-asserted-by":"publisher","first-page":"2258","DOI":"10.1097\/00003246-200112000-00004","volume":"29","author":"JF Payen","year":"2001","unstructured":"Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Crit Care Med. 2001;29:2258\u201363.","journal-title":"Crit Care Med"},{"key":"832_CR15","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1097\/CCM.0b013e3182783b72","volume":"41","author":"J Barr","year":"2013","unstructured":"Barr J, Fraser GL, Puntillo K, Ely EW, G\u00e9linas C, Dasta JF, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41:278\u201380.","journal-title":"Crit Care Med"},{"key":"832_CR16","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/00000542-199311000-00004","volume":"79","author":"TD Egan","year":"1993","unstructured":"Egan TD, Lemmens HJ, Fiset P, Hermann DJ, Muir KT, Stanski DR, et al. The pharmacokinetics of the new short-acting opioid remifentanil (GI87084B) in healthy adult male volunteers. Anesthesiology. 1993;79:881\u201392.","journal-title":"Anesthesiology"},{"key":"832_CR17","first-page":"24","volume":"86","author":"CF Minto","year":"1997","unstructured":"Minto CF, Schnider TW, Shafer SL. Pharmacokinetics and pharmacodynamics of remifentanil. II Model application Anesthesiology. 1997;86:24\u201333.","journal-title":"II Model application Anesthesiology"},{"key":"832_CR18","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1097\/00000542-199709000-00012","volume":"87","author":"JF Hoke","year":"1997","unstructured":"Hoke JF, Shlugman D, Dershwitz M, Micha\u0142owski P, Malthouse-Dufore S, Connors PM, et al. Pharmacokinetics and pharmacodynamics of remifentanil in persons with renal failure compared with healthy volunteers. Anesthesiology. 1997;87:533\u201341.","journal-title":"Anesthesiology"},{"key":"832_CR19","doi-asserted-by":"publisher","first-page":"812","DOI":"10.1097\/00000542-199604000-00008","volume":"84","author":"M Dershwitz","year":"1996","unstructured":"Dershwitz M, Hoke JF, Rosow CE, Micha\u0142owski P, Connors PM, Muir KT, et al. Pharmacokinetics and pharmacodynamics of remifentanil in volunteer subjects with severe liver disease. Anesthesiology. 1996;84:812\u201320.","journal-title":"Anesthesiology"},{"key":"832_CR20","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s00134-012-2697-7","volume":"39","author":"L Chalumeau-Lemoine","year":"2013","unstructured":"Chalumeau-Lemoine L, Stoclin A, Billard V, Laplanche A, Raynard B, Blot F. Flexible fiberoptic bronchoscopy and remifentanil target-controlled infusion in ICU: a preliminary study. Intensive Care Med. 2013;39:53\u20138.","journal-title":"Intensive Care Med"},{"key":"832_CR21","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.accpm.2016.07.004","volume":"36","author":"S Rezaiguia-Delclaux","year":"2017","unstructured":"Rezaiguia-Delclaux S, Laverdure F, Kortchinsky T, Lemasle L, Imbert A, St\u00e9phan F. Fiber optic bronchoscopy and remifentanil target-controlled infusion in critically ill patients with acute hypoxaemic respiratory failure: A descriptive study. Anaesth Crit Care Pain Med. 2017;36:273\u20137.","journal-title":"Anaesth Crit Care Pain Med"},{"key":"832_CR22","doi-asserted-by":"publisher","first-page":"1338","DOI":"10.1164\/rccm.2107138","volume":"166","author":"CN Sessler","year":"2002","unstructured":"Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O\u2019Neal PV, Keane KA, et al. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166:1338\u201344.","journal-title":"Am J Respir Crit Care Med"},{"key":"832_CR23","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1097\/00004714-199008000-00003","volume":"10","author":"DA Chernik","year":"1990","unstructured":"Chernik DA, Gillings D, Laine H, Hendler J, Silver JM, Davidson AB, et al. Validity and reliability of the Observer\u2019s Assessment of Alertness\/Sedation Scale: study with intravenous midazolam. J Clin Psychopharmacol. 1990;10:244\u201351.","journal-title":"J Clin Psychopharmacol"},{"key":"832_CR24","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1034\/j.1399-6576.2002.460403.x","volume":"46","author":"W Puchner","year":"2002","unstructured":"Puchner W, Egger P, P\u00fchringer F, L\u00f6ckinger A, Obwegeser J, Gombotz H. Evaluation of remifentanil as single drug for awake fiberoptic intubation. Acta Anaesthesiol Scand. 2002;46:350\u20134.","journal-title":"Acta Anaesthesiol Scand"},{"key":"832_CR25","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1034\/j.1399-6576.2003.00061.x","volume":"47","author":"R Gonzalez","year":"2003","unstructured":"Gonzalez R, De-La-Rosa-Ramirez I, Maldonado-Hernandez A, Dominguez-Cherit G. Should patients undergoing a bronchoscopy be sedated? Acta Anaesthesiol Scand. 2003;47:411\u20135.","journal-title":"Acta Anaesthesiol Scand"},{"key":"832_CR26","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453\u20137.","journal-title":"Lancet"},{"key":"832_CR27","doi-asserted-by":"publisher","first-page":"1666","DOI":"10.1001\/jama.1974.03240120034016","volume":"230","author":"RE Albertini","year":"1974","unstructured":"Albertini RE, Harrell JH, Kurihara N, Moser KM. Arterial hypoxemia induced by fiberoptic bronchoscopy. JAMA. 1974;230:1666\u20137.","journal-title":"JAMA"},{"key":"832_CR28","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s00134-012-2687-9","volume":"39","author":"C Cracco","year":"2013","unstructured":"Cracco C, Fartoukh M, Prodanovic H, Azoulay E, Chenivesse C, Lorut C, et al. Safety of performing fiberoptic bronchoscopy in critically ill hypoxemic patients with acute respiratory failure. Intensive Care Med. 2013;39:45\u201352.","journal-title":"Intensive Care Med"},{"key":"832_CR29","doi-asserted-by":"publisher","first-page":"1145","DOI":"10.1378\/chest.12-2131","volume":"143","author":"B \u00c7oruh","year":"2013","unstructured":"\u00c7oruh B, Tonelli MR, Park DR. Fentanyl-induced chest wall rigidity. Chest. 2013;143:1145\u20136.","journal-title":"Chest"},{"key":"832_CR30","doi-asserted-by":"publisher","first-page":"5994","DOI":"10.2174\/138161212803582469","volume":"18","author":"M Boom","year":"2012","unstructured":"Boom M, Niesters M, Sarton E, Aarts L, Smith TW, Dahan A. Non-analgesic effects of opioids: opioid-induced respiratory depression. Curr Pharm Des. 2012;18:5994\u20136004.","journal-title":"Curr Pharm Des"},{"key":"832_CR31","doi-asserted-by":"crossref","unstructured":"Del Blanco Narciso BB, Jimeno Fernandez C, Almendral Garrote J, Anadon Baselga MJ, Zaballos Garcia M. Effects of remifentanil on the cardiac conduction system. Our experience in the study of remifentanil electrophysiological properties. Curr Pharm Des. 2014;20:5489\u201396.","DOI":"10.2174\/1381612820666140325102623"},{"key":"832_CR32","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1093\/bja\/aep131","volume":"103","author":"M Zaballos","year":"2009","unstructured":"Zaballos M, Jimeno C, Almendral J, Atienza F, Pati\u00f1o D, Valdes E, et al. Cardiac electrophysiological effects of remifentanil: study in a closed-chest porcine model. Br J Anaesth. 2009;103:191\u20138.","journal-title":"Br J Anaesth"},{"key":"832_CR33","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1097\/00000542-199710000-00061","volume":"87","author":"G DeSouza","year":"1997","unstructured":"DeSouza G, Lewis MC, TerRiet MF. Severe bradycardia after remifentanil. Anesthesiology 1997;87:1019\u201320.","journal-title":"Anesthesiology"},{"key":"832_CR34","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1183\/09031936.98.11051147","volume":"11","author":"PJ Poi","year":"1998","unstructured":"Poi PJ, Chuah SY, Srinivas P, Liam CK. Common fears of patients undergoing bronchoscopy. Eur Respir J. 1998;11:1147\u20139.","journal-title":"Eur Respir J"},{"key":"832_CR35","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1213\/ane.0b013e318184eb31","volume":"108","author":"A Lallo","year":"2009","unstructured":"Lallo A, Billard V, Bourgain J-L. A comparison of propofol and remifentanil target-controlled infusions to facilitate fiberoptic nasotracheal intubation. Anesth Analg. 2009;108:852\u20137.","journal-title":"Anesth Analg"},{"key":"832_CR36","doi-asserted-by":"crossref","unstructured":"Rai MR, Parry TM, Dombrovskis A, Warner OJ. Remifentanil target-controlled infusion vs propofol target-controlled infusion for conscious sedation for awake fibreoptic intubation: a double-blinded randomized controlled trial. BJA: British Journal of Anaesthesia. 2008;100:125\u201330.","DOI":"10.1093\/bja\/aem279"},{"key":"832_CR37","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1513\/AnnalsATS.201611-922CC","volume":"14","author":"MI Soffler","year":"2017","unstructured":"Soffler MI, Rose A, Hayes MM, Banzett R, Schwartzstein RM. Treatment of acute dyspnea with morphine to avert respiratory failure. Ann Am Thorac Soc. 2017;14:584\u20138.","journal-title":"Ann Am Thorac Soc"},{"key":"832_CR38","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1164\/rccm.201101-0005OC","volume":"184","author":"RB Banzett","year":"2011","unstructured":"Banzett RB, Adams L, O\u2019Donnell CR, Gilman SA, Lansing RW, Schwartzstein RM. Using laboratory models to test treatment. Am J Respir Crit Care Med. 2011;184:920\u20137.","journal-title":"Am J Respir Crit Care Med"},{"key":"832_CR39","doi-asserted-by":"crossref","unstructured":"Barnes H, McDonald J, Smallwood N, Manser R. Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness. Cochrane Database Syst Rev [Internet]. 2016 [cited 2021 Jan 30];2016. Available from: https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC6485401\/","DOI":"10.1002\/14651858.CD011008.pub2"},{"key":"832_CR40","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1378\/chest.115.5.1437","volume":"115","author":"S Putinati","year":"1999","unstructured":"Putinati S, Ballerin L, Corbetta L, Trevisani L, Potena A. Patient satisfaction with conscious sedation for bronchoscopy. Chest. 1999;115:1437\u201340.","journal-title":"Chest"},{"key":"832_CR41","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/0954-6111(95)90071-3","volume":"89","author":"JH Greig","year":"1995","unstructured":"Greig JH, Cooper SM, Kasimbazi HJN, Monie RDH, Fennerty AG, Watson B. sedation for fibre optic bronchoscopy. Resp Med. 1995;89:53\u20136.","journal-title":"Resp Med"},{"key":"832_CR42","doi-asserted-by":"publisher","first-page":"775","DOI":"10.2147\/JPR.S118047","volume":"10","author":"F Y\u0131ld\u0131r\u0131m","year":"2017","unstructured":"Y\u0131ld\u0131r\u0131m F, \u00d6zkaya \u015e, Yurdakul AS. Factors affecting patients\u2019 comfort during fiberoptic bronchoscopy and endobronchial ultrasound. J Pain Res. 2017;10:775\u201381.","journal-title":"J Pain Res"},{"key":"832_CR43","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1093\/bja\/aer400","volume":"108","author":"JH Ryu","year":"2012","unstructured":"Ryu JH, Lee SW, Lee JH, Lee EH, Do SH, Kim CS. Randomized double-blind study of remifentanil and dexmedetomidine for flexible bronchoscopy. Br J Anaesth. 2012;108:503\u201311.","journal-title":"Br J Anaesth"},{"key":"832_CR44","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1007\/s00134-011-2375-1","volume":"37","author":"B Clouzeau","year":"2011","unstructured":"Clouzeau B, Bui H-N, Guilhon E, Grenouillet-Delacre M, Leger MS, Saghi T, et al. Fiberoptic bronchoscopy under noninvasive ventilation and propofol target-controlled infusion in hypoxemic patients. Intensive Care Med. 2011;37:1969\u201375.","journal-title":"Intensive Care Med"},{"key":"832_CR45","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/acem.12875","volume":"23","author":"MF Bellolio","year":"2016","unstructured":"Bellolio MF, Gilani WI, Barrionuevo P, Murad MH, Erwin PJ, Anderson JR, et al. Incidence of adverse events in adults undergoing procedural sedation in the emergency department: a systematic review and meta-analysis. Acad Emerg Med. 2016;23:119\u201334.","journal-title":"Acad Emerg Med"},{"key":"832_CR46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00134-013-3117-3","volume":"40","author":"M Schmidt","year":"2014","unstructured":"Schmidt M, Banzett RB, Raux M, Mor\u00e9lot-Panzini C, Dangers L, Similowski T, et al. Unrecognized suffering in the ICU: addressing dyspnea in mechanically ventilated patients. Intensive Care Med. 2014;40:1\u201310.","journal-title":"Intensive Care Med"},{"key":"832_CR47","doi-asserted-by":"publisher","first-page":"137","DOI":"10.3758\/BF03192852","volume":"39","author":"A von Leupoldt","year":"2007","unstructured":"von Leupoldt A, Dahme B. Experimental comparison of dyspnea and pain. Behav Res Methods. 2007;39:137\u201343.","journal-title":"Behav Res Methods"},{"key":"832_CR48","doi-asserted-by":"crossref","unstructured":"Beaussier M, Genty T, Lescot T, Aissou M. Influence of pain on postoperative ventilatory disturbances. Management and expected benefits. Ann Fr Anesth Reanim. 2014;33:484\u20136.","DOI":"10.1016\/j.annfar.2014.07.005"},{"issue":"Suppl 1","key":"832_CR49","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1136\/thoraxjnl-2013-203618","volume":"68","author":"IA Du Rand","year":"2013","unstructured":"Du Rand IA, Blaikley J, Booton R, Chaudhuri N, Gupta V, Khalid S, et al. British Thoracic Society guideline for diagnostic flexible bronchoscopy in adults: accredited by NICE. Thorax. 2013;68(Suppl 1):i1-44.","journal-title":"Thorax"},{"key":"832_CR50","first-page":"443","volume":"33","author":"Y-L Ni","year":"2010","unstructured":"Ni Y-L, Lo Y-L, Lin T-Y, Fang Y-F, Kuo H-P. Conscious sedation reduces patient discomfort and improves satisfaction in flexible bronchoscopy. Chang Gung Med J. 2010;33:443\u201352.","journal-title":"Chang Gung Med J"}],"container-title":["Annals of Intensive Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13613-021-00832-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13613-021-00832-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13613-021-00832-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T06:39:14Z","timestamp":1767767954000},"score":1,"resource":{"primary":{"URL":"https:\/\/annalsofintensivecare.springeropen.com\/articles\/10.1186\/s13613-021-00832-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,16]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["832"],"URL":"https:\/\/doi.org\/10.1186\/s13613-021-00832-6","relation":{},"ISSN":["2110-5820"],"issn-type":[{"value":"2110-5820","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,16]]},"assertion":[{"value":"25 September 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 March 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the amended Declaration of Helsinki and was approved by the local ethics committee (Comit\u00e9 de protection des personnes, Ile de France V, Project number 14983, 2014). All patients consented to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethic approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests to declare.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"48"}}