Sensation of dyspnea during hypercapnia, exercise, and voluntary hyperventilation

Chonan, Tatsuya; Mulholland, M. B.; Leitner, Janice; Altose, Murray D.; Cherniack, Neil S.

doi:10.1152/jappl.1990.68.5.2100

Cited by 59 publications

(32 citation statements)

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“…However, corollary discharge from the brainstem respiratory neurons to the somatosensory cortex is likely integral to the "global" sense of respiratory motor output (Fig. 7) (8,91,92,94,298). Projections to the brain of afferent signals from muscle spindles and Golgi tendon organs as well as from Type III and IV mechano-and metabo-receptors in the diaphragm and chest wall muscles may also contribute to the sense of increased work, effort, or heaviness" of breathing during heavy exercise (Fig.…”

Section: Putative Mechanisms Of Exertional Dyspneamentioning

confidence: 99%

Ventilation and Respiratory Mechanics

Sheel

Romer

2012

Comprehensive Physiology

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During dynamic exercise, the healthy pulmonary system faces several major challenges, including decreases in mixed venous oxygen content and increases in mixed venous carbon dioxide. As such, the ventilatory demand is increased, while the rising cardiac output means that blood will have considerably less time in the pulmonary capillaries to accomplish gas exchange. Blood gas homeostasis must be accomplished by precise regulation of alveolar ventilation via medullary neural networks and sensory reflex mechanisms. It is equally important that cardiovascular and pulmonary system responses to exercise be precisely matched to the increase in metabolic requirements, and that the substantial gas transport needs of both respiratory and locomotor muscles be considered. Our article addresses each of these topics with emphasis on the healthy, young adult exercising in normoxia. We review recent evidence concerning how exercise hyperpnea influences sympathetic vasoconstrictor outflow and the effect this might have on the ability to perform muscular work. We also review sex-based differences in lung mechanics.

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Section: Putative Mechanisms Of Exertional Dyspneamentioning

confidence: 99%

Ventilation and Respiratory Mechanics

Sheel

Romer

2012

Comprehensive Physiology

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“…Stimulation of peripheral and central chemoreceptors by hypercapnia [20] and/or hypoxia, irritant receptors [21] and possibly C fibres [22] increases breathlessness. There is physiological evidence to support this hypothesis; for example, constraining respiratory rate and tidal volume when NRD is increased during carbon dioxide rebreathing increases breathlessness [23]. Vibration over parasternal intercostal muscles in phase with inspiration, which stimulates muscle spindles and increases appropriate afferent feedback, reduces breathlessness in patients with chronic lung disease, but vibration over the parasternal region during expiration increases breathlessness [24].…”

Section: Physiology Of Breathlessnessmentioning

confidence: 99%

A physiological model of patient-reported breathlessness during daily activities in COPD

Jolley

Moxham

2009

Eur Respir Rev

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Breathlessness during daily activities has a significant impact on quality of life in chronic obstructive pulmonary disease. Herein, we present a physiological model of patient-reported breathlessness based on the relationship between ventilatory load, respiratory muscle capacity, neural respiratory drive and neuromechanical dissociation during daily activities. This model should facilitate an understanding of the mechanisms driving increased intensity of breathlessness during daily activities and the relief of breathlessness following medical or surgical interventions. The model should also provide a structure on which to base the development of patient-reported outcome instruments to measure the severity of breathlessness during daily activities in chronic obstructive pulmonary disease.

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“…Furthermore, both scales have similar reproducibility [28,44]. In this study, as others, we used the visual analogical scale, which is widely used to assess respiratory perception [1,10,20]. The advantage of this scale is that it assesses a dyspnea score at each effort level during an incremental exercise and thereafter allows to obtain a time course of dyspnea over the exercise period.…”

Section: Methodological Considerationsmentioning

confidence: 99%

Relationship between Dyspnea Increase and Ventilatory Gas Exchange Thresholds during Exercise in Children with Surgically Corrected Heart Impairment

et al. 2007

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To study the relationship between the onset of an increase in dyspnea and ventilatory threshold (VT) in children with congenital heart impairment, sixteen young subjects underwent a cardiopulmonary exercise test with dyspnea perception and ventilatory gas exchange assessments. Dyspnea score was measured from a visual analogical scale at rest and during each step of an incremental exercise test. Dyspnea score was plotted against oxygen uptake and the onset of an increase in dyspnea (DT) was determined when a brutal disruption occurs on the dyspnea score-oxygen uptake curve. VT was defined from gas exchange according to Beaver's method. The first breakdown point in the oxygen uptake-carbon dioxide production relationship locates VT. Oxygen uptake (V(.-)O (2)), pulmonary ventilation (V(.-)E), heart rate (HR), oxygen pulse (O (2) pulse = V(.-)O (2)/HR), carbon dioxide production (V(.-)CO (2)) and power output (P) were measured both at VT and DT effort level. Results pointed out that there was no significant difference between the cardiorespiratory variables measured respectively at VT and DT: V(.-)O (2) (VTV(.-)O (2) = 16.71 +/- 2.65 vs. DTV(.-)O (2) = 18.34 +/- 5.74 ml x kg (-1) x min (-1)), V(.-)E (VTV(.-)E = 24.33 +/- 6.86 vs. DTV(.-)E = 26.82 +/- 9.59 l x min (-1)), (VTV(.-)CO (2) = 789.31 +/- 165.17 vs. DTV(.-)CO (2) = 924.02 +/- 342.28 ml x min (-1)), HR (VTHR = 116 +/- 10 vs. DTHR = 123 +/- 20 beat x min (-1)), O (2) pulse (VT O (2) pulse = 7.83 +/- 2.00 vs. DT O (2) pulse = 8.01 +/- 2.13 ml x kg (-1) x beat (-1)), and P (VTP = 43 +/- 16 vs. DTP = 52 +/- 27 W). Moreover, the cardiorespiratory variables measured at DT and VT were closely related: V(.-)O (2) (r = 0.64, p < 0.01), V(.-)E (r = 0.51, p < 0.01), HR (r = 0.75, p < 0.02), O (2) pulse (r = 0.90, p < 0.001), and P (r = 0.80, p < 0.01). In addition, according to Bland and Altman's procedure, the onset of dyspnea increase and ventilatory threshold were shown in close agreement for the cardiorespiratory variables measured at these effort levels. The standard errors of the estimates were low. It was concluded that dyspnea and ventilatory gas exchange thresholds occur concomitantly and were strongly correlated in children with congenital heart impairment. The use of the onset of dyspnea increase for aerobic capacity assessment may be a good alternative to ventilatory gas exchange threshold measurement.

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Sensation of dyspnea during hypercapnia, exercise, and voluntary hyperventilation

Cited by 59 publications

References 0 publications

Ventilation and Respiratory Mechanics

Ventilation and Respiratory Mechanics

A physiological model of patient-reported breathlessness during daily activities in COPD

Relationship between Dyspnea Increase and Ventilatory Gas Exchange Thresholds during Exercise in Children with Surgically Corrected Heart Impairment

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