Invisible suffering: recognizing signs of anxiety in mechanically ventilated patients in the intensive care unit

Patients on mechanical ventilation in intensive care units often experience “invisible suffering” associated with anxiety. This emotional response arises from loss of control, inability to communicate, sensations of suffocation, and constant exposure to invasive procedures. Recognizing signs of anxiety is essential for ensuring quality of care and preventing long-term consequences. The most significant factor contributing to anxiety is the inability to communicate. Patients report feelings of isolation, frustration, and helplessness, which further intensify fear and uncertainty 1 . The use of alternative communication methods can alleviate these difficulties, but such methods are rare - ly applied systematically. Another key source of anxiety is the respiratory experience of dyspnea and the sensation of air hunger. This phenomenon may occur even when ventilator parameters are technically optimal. The experience of breathlessness directly triggers fear and panic and is considered one of the most distressing experiences during mechanical ventilation 2 . Additional sources of distress include