Dyspnea perception in cystic fibrosis patients

Abstract

We evaluated dyspnea perception in cystic fibrosis patients compared with normal subjects, during an inspiratory resistive loading test and 6-min walk test. We also evaluated the correlation between dyspnea scores induced by resistive loads and by the 6-min walk test. In this prospective, cross-sectional study, 31 patients with cystic fibrosis (≥15 years of age) and 31 age-, gender-, and ethnicity-matched healthy volunteers (20 females and 11 males per group) underwent inspiratory resistive loading, spirometry, and the 6-min walk test. As the magnitude of the inspiratory loads increased, dyspnea scores increased (P<0.001), but there was no difference between groups in dyspnea score (P=0.654). Twenty-six (84%) normal subjects completed all the resistive loads, compared with only 12 (39%) cystic fibrosis patients (P<0.001). Dyspnea scores were higher after the 6-min walk test than at rest (P<0.001), but did not differ between groups (P=0.080). Post-6-min walk test dyspnea scores correlated significantly with dyspnea scores induced by resistive loads. We conclude that dyspnea perception induced in cystic fibrosis patients by inspiratory resistive loading and by 6-min walk test did not differ from that induced in normal subjects. However, cystic fibrosis patients discontinued inspiratory resistive loading more frequently. There were significant correlations between dyspnea perception scores induced by inspiratory resistance loading and by the 6-min walk test. This study should alert clinicians to the fact that some cystic fibrosis patients fail to discriminate dyspnea perception and could be at risk for delay in seeking medical care.

Perception of Pulmonary Function in Children with Asthma and Cystic Fibrosis

“…4 Additionally, Ziegler et al found that CF patients reported only mild to moderate dyspnea during resistive loaded breathing despite significant impairment in pulmonary function, possibly suggesting a blunted perception of dyspnea. 12 Among children with asthma, we found no association between ACT scores and estimation accuracy (not shown), nor between ACT and measured FEV 1 . This suggests there is a discrepancy between the perception of asthma control, the perception of lung function, and measured FEV 1 .…”

Dyspnea perception during the inspiratory resistive loads test in obese subjects waiting bariatric surgery

“…The identification of individuals with low perception of dyspnea is relevant, since this condition is significantly associated with worse outcomes regarding morbidity and mortality 12,13 . The use of the inspiratory resistive load system during ventilation is a simple, safe and practical approach to identify subjects with low dyspnea perception 14,15 .…”

Qualitative dimensions of exertional dyspnea in adults with cystic fibrosis

“…Although prior studies in CF have focused on the intensity of dyspnea during exercise testing (27) or inspiratory resistive loading (32), none to date have systematically characterized the evolution of the qualitative dimensions of dyspnea during exercise. The objective of this study was to examine the intensity and qualitative dimensions of dyspnea experienced by subjects with CF during incremental exercise testing compared with well-matched healthy controls.…”