Recent Advances in Dyspnea

Mahler, Donald A.; O’Donnell, Denis E.

doi:10.1378/chest.14-0800

Cited by 115 publications

(60 citation statements)

References 96 publications

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“…However, that improvements in patient-reported dyspnoea with bronchodilator therapy during CWRETs are variable is probably due to measurement variability in this outcome as well as the modest numbers of patients in several of these studies [156]. Oxygen therapy significantly reduces dyspnoea (CR-10) by a pooled mean of −1.15 (95% CI −1.65-−0.65) in COPD patients who desaturated during exercise [128]; and a statistically significant, but clinically very small, effect in mildly or nonhypoxaemic COPD patients who are dyspnoeic at rest, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…The CR-10 scale is derived from the original Borg 6-20-point perceived exertion scale (corresponding to a heart rate range of 60-200 bpm) [155,156], modified to an open-ended 10-point scale including written indicators of severity to anchor specific numbers on the scale [153]. This was updated in 2010 with categories similar to the original 1982 scale, but having 19 points [155,156]. In addition, a "modified CR-10 Borg scale", which is not open-ended, is frequently used [155,156].…”

Section: Dyspnoeamentioning

confidence: 99%

“…This was updated in 2010 with categories similar to the original 1982 scale, but having 19 points [155,156]. In addition, a "modified CR-10 Borg scale", which is not open-ended, is frequently used [155,156]. Readers should be aware that all of them are described (and frequently misquoted) as Borg or CR-10 scales in the literature [155].…”

Section: Dyspnoeamentioning

confidence: 99%

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Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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This document reviews 1) the measurement properties of commonly used exercise tests in patients with chronic respiratory diseases and 2) published studies on their utilty and/or evaluation obtained from MEDLINE and Cochrane Library searches between 1990 and March 2015.Exercise tests are reliable and consistently responsive to rehabilitative and pharmacological interventions. Thresholds for clinically important changes in performance are available for several tests. In pulmonary arterial hypertension, the 6-min walk test (6MWT), peak oxygen uptake and ventilation/carbon dioxide output indices appear to be the variables most responsive to vasodilators. While bronchodilators do not always show clinically relevant effects in chronic obstructive pulmonary disease, high-intensity constant work-rate (endurance) tests (CWRET) are considerably more responsive than incremental exercise tests and 6MWTs. High-intensity CWRETs need to be standardised to reduce interindividual variability. Additional physiological information and responsiveness can be obtained from isotime measurements, particularly of inspiratory capacity and dyspnoea. Less evidence is available for the endurance shuttle walk test. Although the incremental shuttle walk test and 6MWT are reliable and less expensive than cardiopulmonary exercise testing, two repetitions are needed at baseline. All exercise tests are safe when recommended precautions are followed, with evidence suggesting that no test is safer than others. @ERSpublications A review of exercise testing to evaluate interventions aimed to improve exercise tolerance in respiratory patients

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Section: Discussionmentioning

confidence: 99%

Section: Dyspnoeamentioning

confidence: 99%

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Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

et al. 2016

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“…These interventions appear to be straightforward when adhering to the common recommendations and guidelines [113][114][115]. Moreover, with the pathophysiologic understanding of dyspnea as outlined above, the therapeutic options, beyond exercise, now entail the standard drug therapies or invasive/surgical procedures [116]. Identification of the receptors and fibers involved may provide a more focused therapeutic approach.…”

Section: General Therapeutic Principles Of Dyspneamentioning

confidence: 99%

Dyspnea related to reversibly-binding P2Y12 inhibitors: A review of the pathophysiology, clinical presentation and diagnostics

Unverdorben

Parodi

Storey

2016

International Journal of Cardiology

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“…Dyspnoea is an important cause of exercise limitation and reduced quality of life for COPD patients (2). Notably, inhaled bronchodilators as the mainstay of pharmacologic treatment of COPD have been known to alleviate dyspnoea and improve exercise tolerance in these patients.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of neural respiratory drive for the assessment of bronchodilator responsiveness in patients with chronic obstructive pulmonary disease: an exploratory study

Li³

et al. 2016

J. Thorac. Dis.

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Background: Conventional lung function parameters, such as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ) and inspiratory capacity (IC) are often used to assess the therapeutic outcomes of bronchodilators, but they lack sensitivity. A novel indicator, namely efficiency of neural respiratory drive (NRD), may objectively evaluate the physiological changes in patients with chronic obstructive pulmonary disease (COPD). We investigated whether this indicator could be used to more accurately assess the responsiveness to inhaled bronchodilators. Methods: Thirty-six subjects with moderate-to-severe COPD were randomized into group A (n=18) and group B (n=18). Participants in group A inhaled 400 μg placebo, 400 μg salbutamol and 80 μg ipratropium in sequence whereas those in group B had the salbutamol and ipratropium reversed.

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Recent Advances in Dyspnea

Cited by 115 publications

References 96 publications

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

Dyspnea related to reversibly-binding P2Y12 inhibitors: A review of the pathophysiology, clinical presentation and diagnostics

Efficiency of neural respiratory drive for the assessment of bronchodilator responsiveness in patients with chronic obstructive pulmonary disease: an exploratory study

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