Intensive Care-Respiratory Distress Observation Scale
Dyspnea is a distressing symptom that can occur in the intensive care unit (ICU), in spite of treatments. Identifying it is of major clinical relevance. This can be difficult in patients who are not able to communicate with their caregivers.
The Respiratory Distress Observation Scale (RDOS) has been developed to help indentify dyspnea in non-communicant palliative care patients (1).
The IC-RDOS is a variant of the RDOS that has been developed to take into account certain particularities of ICU patients.
As of April 2015, the IC-RDOS (2) has been shown to relate with dyspnea in ICU patients able to rate dyspnea on a visual analog scale (D-VAS). In the setting of the initial validation study, an IC-RDOS of 2.4 or more predicted a D-VAS of 4 or more with 72% sensitivity and 72% specificity, and an IC-ROS of 6.3 or more predicted a D-VAS of 4 or more with 100% specificity.
Generalization and validation in non-communicant patients remain to be established. However, even though it is not possible to be certain that a given non-communicant patient is or not dyspneic according to IC-RDOS, this scale can safely be used to prompt a "risk of dyspnea" check-list in this setting. IC-RDOS can be calculated on this page or by downloading the IC-RDOS app.
1. Campbell ML, Templin T, Walch J. A Respiratory Distress Observation Scale for patients unable to self-report dyspnea. J Palliat Med 2010 ;13:285-90.
2. Persichini R, Gay F, Schmidt M, Mayaux J, Demoule A, Morelot-Panzini C, Similowski T. Diagnostic accuracy of respiratory distress observation scales as surrogates of dyspnea self-report in intensive care unit patients. Anesthesiology 2015 Oct;123(4):830-7. http://www.ncbi.nlm.nih.gov/pubmed/26259140