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At least 19 recordsLinked to original sources
PubMed1992

[Evaluation of the relations between exercise tolerance, dyspnea and pulmonary function in patients with chronic obstructive lung diseases].

We studied 53 patients with severe COPD (FEV1 0.92 +/- 0.40 1, PaO2 61 +/- 9 mm Hg), aged 58 +/- 9 years, to assess the relationship between ability to exercise (6 MWD), dyspnea and baseline lung function parameters. Dyspnea at rest (D1) and during exercise (D2) was evaluated using VAS. During exercise dyspnea increased by 41 +/- 28, and oxygen saturation (StcO2) decreased from 92 +/- 3% to 84 +/- 9%. The fall in the StcO2 of more than 3% was observed in 42 patients (79%). We found that 6 MWD significantly correlated with the FEV1, VC and maximal dyspnea during exercise. There was no correlation between exercise tolerance and resting PaO2, PaCO2, severity of dyspnea at rest and the increase in dyspnea during exercise as well as with the resting and exercise StcO2 and the fall in StcO2 during walk. Dyspnea at rest and during exercise significantly correlated with air flow limitation and StcO2 at rest, during exercise and the exercise decrease in StcO2. There was a significant correlation between the fall in StcO2 during exercise and blood gases at rest. No relationship between the fall in StcO2 and the increase in dyspnea during exercise was found.

Dyspnea↗
PubMedDate not supplied

Dyspnea.

Dyspnea is the medical term for the patient's or subject's complaint of shortness of breath. It encompasses the respiratory discomfort experienced in many different diease states as well as the shortness of breath felt by a normal subject during or after strenuous exercise. Several parameters which have been shown to correlate with the onset or severity of dyspnea are described, including reduced vital capacity, the ratio of minute ventilation to vital capacity, reduced breathing reserve, the work of breathing, and the oxygen cost of breathing. Attempts at quantitation of dyspnea have usually consisted of measuring physiological parameters associated with the sensation, such as the "dyspneic index". The direct measurement of respiratory sensations using modern psycho-physical methods is at an early stage of development. Since the observation that the existence of dyspnea is often unrelated to any disturbance of arterial blood gas composition, it has been generally held that the mechanism of dyspnea is primarily neurophysiological. The neural pathways may conceptually be divided into those which transmit the "dyspnea message" from the respiratory apparatus to integrating centers in the brain, and those concerned with subsequently bringing the sensation to the level of consciousness. It seems likely that there is no single sensing mechanism and neural pathway which will be able to explain dyspnea in the diverse populations of patients and subjects who experience unpleasant respiratory sensations. Three theories concerning mechanisms of dyspnea are briefly described: "length-tension inappropriateness", vagal afferent activity especially from the J-receptors, and the recent concept of diaphragmatic fatigue. Some specific characteristics of the shortness of breath experienced in certain disease states are described, including chronic bronchitis and emphysema, bronchial asthma, pulmonary fibrosis and congestive heart disease.

Asthma↗
PubMed1975

[Mechanics of breathing and exertion dyspnea in silicosis (author's transl)].

Mechanics of breathing as studied in patients with different stages of silicosis in rest and during exercise show the following: dynamic compliance and work against elastic and viscous resistances could not be found to be decisive indices of exertion dyspnea. Evidence of exertion dyspnea could only be achieved by means of the ration VT/PT (VT equals tidal volume, PT equals tidal esophageal pressure). Exertion dyspnea was observed at less than 0,081 VT per cm H20 PT. In accordance with Campbell and Howell, dyspnea is seen as an inappropriateness between ventilation and pressure needed.

Dyspnea↗
PubMed1992

[The treatment of terminal dyspnea].

Dyspnea can be defined as an unusual perception of respiration and/or urge to breath more than usual. Up to 70% of all tumour patients suffer at one time from this complaint, and often only an incomplete palliation is achieved. Dyspnea in the tumour patient is often associated with anxiety, which leads itself to a further exacerbation of dyspnea (through increased respiratory work and dead-space ventilation). A thorough evaluation should exclude treatable causes of dyspnea such as atelectasis, pleural effusions, pneumonias, congestive heart failure, pulmonary emboli, reversible exacerbations of coexisting obstructive lung disease, central tumour obstruction and pericardial effusion. Therapeutic measures include bronchoscopic suction of retained secretions and physical measures to reduce secretions. Supplemental oxygen is indicated in hypoxemic patients and in those who derive benefit of it. The nonspecific drug therapy with benzodiazepines and/or opiates remains clinically useful, although its efficacy is questioned by some controlled studies.

Airway Obstruction↗
PubMed1992

Characterization of aeroallergen-induced dyspnea in unrestrained guinea pigs by bias-flow-ventilated whole body plethysmography.

Aeroallergen-induced dyspnea in guinea pigs was associated with an increase in amplitude in the box pressure fluctuations (212%) and pseudo-flow signal (604%) and an 80% decline (from 0.19 to 0.04 s) in relaxation time (the time it takes the box pressure signal to drop from its peak to 1/3 of its peak value). All of these lung dysfunction changes were highly significant (P < 0.001). Pyrilamine (1 mg/kg, p.o., -2 h) inhibited dyspnea (delta P and delta F) by 50-53%. This technique allows quantitative analysis of allergic dyspnea in conscious, unrestrained guinea pigs.

Aerosols↗
PubMed1976

[Wallenberg's syndrome with sleep-induced dyspnea--a case study].

One case with Wallenberg's syndrome followed by the neck clipping of the posterior inferior cerebellar aneurysm was reported. The patient was 49 years old female with the subarachnoid hemorrhage, who had previously no history of the cardiovascular disease. The vertebral angiogram revealed a saccular aneurysm of the left vertebral artery at the origin of the posterior inferior cerebellar artery. The preoperative neurological examination were normal, except for the slight degree of the meningeal irritation. The surgical intervention was successfully performed on 39th day after the subarachnoid hemorrhage. Postoperative course was eventful, presenting the typical Wallenberg's syndrome, which was complicated the accompanying signs. The troublesome accompanying signs were chiefly automatic respiratory dysfunction (sleep-induced dyspnea), autonomic dysfunction (Horner's syndrome, perspiration, hypertension), and restless confusion. The postoperative vertebral angiogram showed the obliteration of the aneurysm and the sufficient circulation of the vertebrobasilar system, especially the posterior inferior cerebellar artery. The mechanism of "sleep-induced dyspnea" was discussed in detail from the literatures. In addition to the above mentioned, it should be stressed that the recognition of "sleep-induced dyspnea" and the other accompanying signs are important for the treatment of the patient with the brain stem lesion.

Cerebellar Diseases↗
PubMed1979

[Dyspnea symptoms in coalminers].

One of the authors observed an excess of dyspnea complaints in coalminers without bronchitis, massive fibrosis or emphysema in different epidemiological surveys. An abnormally high prevalence of dyspnea complaints in coalminers has also been reported by other investigators in different countries. It seems therefore necessary to study whether the type of complaints observed in our country can be validated by appropriate functional investigations. A research on this problem is in progress in our laboratory. In this preliminary publication a review of the literature concerning the mechanisms of dyspnea is presented. Such a study was necessary in order to make an adequate choice of the functional measurements usable for our validation study.

Carbon Dioxide↗
PubMed1992

[Dyspnea at rest and after exercise and the mental status of patients with chronic obstructive lung diseases].

Thirty two patients with severe COPD were studied. We evaluated relationships between their psychological status, lung function parameters, exercises tolerance (6 MWD test) and dyspnea at rest and exercise (visual analogue scale). Patients demonstrated increased level of anxiety and psychological tension. In nearly half of the patients depression, low self-esteem and disbelief in the efficiency of therapy were observed. The correlations between the psychological status and the exercise tolerance hasn't been found. The correlation between the high level of depression and impairment of the lung function was found. The high increase in dyspnea score during exercises was connected with low self-esteem, although at rest the dyspnea level in those patients was low.

Adult↗
PubMedDate not supplied

Arterial carbon dioxide tension and dyspnea in chronic bronchitis and pulmonary emphysema.

The severity of dyspnea (MRC scale) was confronted to the blood carbon dioxide tension (PaCO2) in 45 patients with chronic nonspecific lung disease having moderate or severe airway obstruction (FEV1.0 of less than 1.5 liters). The patients were classified as "bronchitic", "emphysematous" and "intermediate" using a 10- criterion (clinical, roentgenologic and biological) "emphysema score". No correlation between dyspnea grade and PaCO2 was found in "bronchitic" and "intermediate" patients; in the "emphysematous" subgroup PaCO2 tended to rise as dyspnea was more severe, but the linear correlation coefficient (r= +0.37) did not reach the significance threshold, which is high (0.468) for such a limited number of observations.

Adult↗
PubMed1975

Microscopic pulmonary tumor emboli associated with dyspnea.

A syndrome is described in which severe, clinically unexplained dyspnea is found at autopsy to be caused by multiple microscopic tumor emboli. Such a situation was found in 8 of 16 cases of multiple microscopic tumor emboli in the pulmonary arteries without significant lymphatic or parenchymal involvement of the lungs. The origins oftumor emboli included carcinomas of the prostate, breast, stomach, pancreas, and liver. In the 8 cases that presented with unexplained dyspnea, initial physical, roentgenographic, and electrocardiographic examinations were not diagnostic. Clinical or morphological evidence of car pulmonale was pre emboli did not invade the walls of pulmonary vessels but were frequently associated with thrombi. Recognition of this clinicopathologic entity becomes important as progress is made in cancer therapy.

Adult↗
PubMed1975

Exertional dyspnea and cough as preludes to acute attacks of bronchial asthma.

Although wheezing is believed to be a cardinal manifestation of asthma, some patients with this disorder may not present with wheezing, but rather with either exertional dyspnea or cough. In 14 such patients with dyspnea, there was peripheral airway dysfunction with markedly elevated residual volumes, frequency dependence of dynamic compliance and depressed flow rates in the middle-vital-capacity range, whereas specific conductance and one-second forced expiratory volumes were normal. Circumstantial evidence suggests that mucosal edema or mucous secretions may have been responsible. In seven patients with cough, studies revealed a more severe obstructive pattern that appeared to be the result of increased large-airway resistance, and the patients' response to isoproterenol indicated that contraction of bronchial smooth muscle may have been principally responsible. Thus, intermittent episodes of cough or breathlessness may represent variant aspects of asthmatic attacks.

Acute Disease↗
PubMed1977

Dyspnea in divers at 49.5 ATA: mechanical, not chemical in origin.

Pulmonary function was studied in six divers living in a hyperbaric chamber at a pressure nearly fifty times normal (49.5 atmospheres absolute (ATA), equivalent to 488 m or 1600 ft seawater (fsw)). As expected, ventilatory function was reduced. At 49.5 ATA, maximum voluntary ventilation (MVV) was 45% less than the control value. Instantaneous rates of gas flow during forced expiration were similarly reduced, especially those flow rates measured high in the lung volume. These reductions occurred despite an apparent increase in functional residual capacity (FRC) and the use of transpulmonary pressures considerably greater than those exerted during the same maneuvers at normal (sea-level) pressure. During underwater work at 49.5 ATA, the divers rapidly became exhausted at moderate levels of oxygen consumption (1.9 liters/min), showing severe dyspnea and impending syncope. These symptoms were not due to retention of carbon dioxide, nor to hemodynamic or metabolic causes. Thus, dense gas breathing, like asthma, exemplifies a state in which severe dyspnea may occur with normal or low arterial carbon dioxide and normal oxygen transport. The physiological adjustments the divers employed were similar to those seen in acute asthma, imposing an elastic load in addition to the flow-resistive work of breathing a gas mixture eight times as dense as air. Although men can do moderate work under conditions similar to those of this experiment, they will have only a limited physiological reserve available to meet the possibilities of emergencies or respiratory infections.

Adult↗
PubMed1975

False atrial dissociation (the Deitz-Marques phenomenon) and its dependence on dyspnea.

Three cases of false atrial dissociation (the Deitz-Marques phenomenon) were presented to show the dependence of this phenomenon on dyspnea. 2) The pseudo-P wave of the Deitz-Marques phenomenon coincided with the beginning of inspiration. 3) In a case of silicotuberculosis, the length of the pseudo-fibrillation was nearly equal to that of laborious inspiration. 4) In a case of aspiration pneumonia, every second cardiac contraction was synchronized with the beginning of inspiration two hours before death. 5) In a case of hyperpotassemia, the pseudo-P wave persisted even after the disappearance of the sinus P wave. 6) The pseudo-P wave was not affected by retrograde activation of the atria by the A-V junctional impulse.

Aged↗
PubMed1976

Acute acromegalic dyspnea.

A case of acute "acromegalic dyspnea" due to vocal cord fixation and subglottic mucosal hypertrophy is reported. The patient was treated by intubation, tracheostomy, stereotactic implantation of radioisotopes 192Ir and 198Au via the transsphenoidal route.

Acromegaly↗
PubMed1978

Respiratory dyskinesias: extrapyramidal dysfunction and dyspnea.

Four patients had acute dyspnea and chest pain due to primary neurologic disease, not to cardiac or pulmonary disorders. They suffered from severe, involuntary respiratory dyskinesias, which resulted in an irregular respiratory rate, shortness of breath, and chest discomfort. These respiratory dyskinesias occurred as one aspect of more generalized choreiform movement disorders. Three patients had neuroleptic-induced tardive dyskinesias, and one had levodopa-induced dyskinesias. As a result of their ages and the nature of their complaints, some of these patients were originally thought to have cardiac and pulmonary disorders. Respiratory dyskinesias should be considered as a possible cause of respiratory distress in patients with extrapyramidal dysfunction.

Adult↗
PubMedDate not supplied

Dyspnea in the patient with cardiopulmonary disease.

Dyspnea in the patient with cardiopulmonary disease has been defined and discussed, emphasizing those conditions which increase the work of breathing: increased elastic resistance; increased airway obstruction; and deformities of the chest wall, lung, and pleura. Methods of assessing the cardiopulmonary status of the patient as it relates to each condition were presented. Determining and understanding such clinical signs as patterns of breathing, cough and secretions, râles, rhonchi, wheezes, diminished or augmented breath sounds, poor or unequal expansion of the rib cage, and dullness or hyperresonance on percusion is extremely important for the nurse in order to accurately and comprehensively make a nursing assessment. Such an assessment can provide the information necessary to plan more effectively for the care of the patient with cardiopulmonary disease.

Airway Obstruction↗
PubMed1977

Neuropathy presenting as prolonged dyspnea. Case report and review of literature.

Polyneuropathy presented as isolated respiratory muscular paralysis. Transdiaphragmatic pressure measurements, nerve conduction studies, electromyography, and biopsy of intercostal muscle confirmed the nature of the process. Patients with unexplained respiratory insufficiency must be carefully evaulated for underlying neuromuscular disease.

Adult↗