Assessment of Symptom Burden Using the ESAS in Patients with Hypercapnic Respiratory Failure Receiving Noninvasive Mechanical Ventilation

Abstract

Aim: The success of noninvasive mechanical ventilation (NIV), which is used in the treatment of hypercapnic respiratory failure (HRF), largely depends on patient adherence. One of the key components of adherence is effective symptom control. Therefore, it is recommended that symptoms other than dyspnea be systematically assessed in patients requiring NIV. This study was designed to evaluate the symptom burden of such patients using the Edmonton Symptom Assessment Scale (ESAS). Material and Method: This study, conducted between January 2025 and March 2025, included patients undergoing NIV. The demographic characteristics and comorbidities of the patients were assessed. Symptoms and their severity were evaluated using the ESAS. Additionally, patients were divided into two groups: those with prior NIV experience and those undergoing NIV for the first time, and their symptom burden was analyzed accordingly. Results: The mean age of the patients included in the study was 69±12 years, with 68.4% being male. According to the ESAS results, the most frequently reported symptoms were dyspnea (6.21±1.05), overall well-being (5.65±2.49), and fatigue (5.03±1.74). When comparing symptom burden based on NIV experience, dyspnea scores were significantly higher in patients with prior NIV use (p<0.001), whereas abdominal bloating and drowsiness were more pronounced in first-time NIV users (p<0.001, p=0.049). Gender-based analysis revealed that pain scores were significantly higher in female patients compared to males (p=0.030). Regarding age groups, older patients exhibited more pronounced dyspnea and appetite loss, while younger patients had higher scores for pain, anxiety, and overall well-being (p<0.05). Conclusion: This study demonstrated that symptom burden is significant in patients undergoing NIV and that age, gender, and prior NIV experience influence symptom presentation. These findings highlight the importance of comprehensive assessment approaches to personalize symptom management and enhance patient adherence.

Keywords

• Edmonton Symptom Assessment Scale
• noninvasive mechanical ventilation
• compliance
• adherence

Kaynakça

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