The Control of Breathing in Clinical Practice

Caruana-Montaldo, Brendan; Gleeson, Kevin; Zwillich, Clifford W.

doi:10.1378/chest.117.1.205

Cited by 130 publications

(69 citation statements)

References 95 publications

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“…Yet, the BioHarness provided reasonably accurate measurements of RR during a sustained period of exercise while showing less accurate, but comparable, results from previous studies that tested a portable plethysmographic device indicating a correlation coefficient of 0.92 (ranging from rest to running at 8.9 km·h −1 ) [18] and 0.98 (walking/running at 50 % VȮ 2max in protective clothing) [5]. It is also perhaps not surprising that lower variability for RR than HR was noted for all phases of the current study insofar as while both RR and HR increase abruptly with exercise onset [4,15], respiration follows a more gradual increase as exercise continues [4] and reaches a steady state that is related to the metabolic demands of exercise [13]. Finally, despite the environmental chamber being lined with stainless steel on its inner and exterior surfaces, no interference with data transmission to a computer located outside of the chamber occurred, a problem we have previously encountered with other systems.…”

Section: Discussionsupporting

confidence: 89%

Measurement Accuracy of Heart Rate and Respiratory Rate during Graded Exercise and Sustained Exercise in the Heat Using the Zephyr BioHarnessTM

et al. 2012

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The Zephyr BioHarness ™ was tested to determine the accuracy of heart rate (HR) and respiratory rate (RR) measurements during 2 exercise protocols in conjunction with either a laboratory metabolic cart (Vmax) or a previously validated portable metabolic system (K4b 2 ). In one protocol, HR and RR were measured using the BioHarness and Vmax during a graded exercise up to VȮ 2max (n = 12). In another protocol, HR and RR were measured using the BH and K4b 2 during sustained exercise (30 % and 50 % VȮ 2max for 20 min each) in a hot environment (30°C, 50 % relative humidity) (n = 6). During the graded exercise, HR but not RR, obtained from the BioHarness was higher compared to the Vmax at baseline and 30 % VȮ 2max (p < 0.05), but showed no significant difference at other stages with high correlation coefficients for both HR (r = 0.87-0.96) and RR (r = 0.90-0.99 above 30 % VȮ 2max ). During the exercise in the heat, there were no significant differences between the BioHarness and K4b 2 system. Correlation coefficients between the methods were low for HR but moderately to highly correlated (0.49-0.99) for RR. In conclusion, the BioHarness is comparable to Vmax and K4b 2 over a wide range of VȮ 2 during graded exercise and sustained exercise in the heat.

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Section: Discussionsupporting

confidence: 89%

Measurement Accuracy of Heart Rate and Respiratory Rate during Graded Exercise and Sustained Exercise in the Heat Using the Zephyr BioHarnessTM

et al. 2012

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“…The heart is not a metronome and its beats do not have the regularity of a clock, so changes in HR, defined as heart rate variability (HRV), are normal and expected and indicate the heart's ability to respond to multiple physiological and environment stimuli, among them, breathing, physical exercise, mental stress, hemodynamic and metabolic changes, sleep and orthostatism, as well as to compensate disorders induced by diseases [1,4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Noções básicas de variabilidade da frequência cardíaca e sua aplicabilidade clínica

Vanderlei

Pastre

Hoshi

et al. 2009

Rev Bras Cir Cardiovasc

673

499

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Autonomic nervous system (ANS) plays an important role in the regulation of the physiological processes of the human organism during normal and pathological conditions. Among the techniques used in its evaluation, the heart rate variability (HRV) has arising as a simple and non-invasive measure of the autonomic impulses, representing one of the most promising quantitative markers of the autonomic balance. The HRV describes the oscillations in the interval between consecutive heart beats (RR interval), as well as the oscillations between consecutive instantaneous heart rates. It is a measure that can be used to assess the ANS modulation under physiological conditions, such as wakefulness and sleep conditions, different body positions, physical training and also pathological conditions. Changes in the HRV patterns provide a sensible and advanced indicator of health involvements. Higher HRV is a signal of good adaptation and characterizes a health person with efficient autonomic mechanisms, while lower HRV is frequently an indicator of abnormal and insufficient adaptation of the ANS, provoking poor patient's physiological function. Because of its importance as a marker that reflects the autonomic nervous system activity on the sinus node and as a clinical instrument to assess and identify health involvements, this study reviews conceptual aspects of the HRV, measurement devices, filtering methods, indexes used in the HRV analyses, limitations in the use and clinical applications of the HRV.Descriptors: Autonomic nervous system. Heart rate. Parasympathetic nervous system. Sympathetic nervous system. ResumoO sistema nervoso autônomo (SNA) desempenha um papel importante na regulação dos processos fisiológicos do organismo humano tanto em condições normais quanto patológicas. Dentre as técnicas utilizadas para sua avaliação, a variabilidade da frequência cardíaca (VFC) tem emergido como uma medida simples e não-invasiva dos impulsos autonômicos, representando um dos mais promissores marcadores quantitativos do balanço autonômico. A VFC descreve as oscilações no intervalo entre batimentos cardíacos consecutivos (intervalos R-R), assim como oscilações entre frequências cardíacas instantâneas consecutivas. Trata-se de uma medida que pode ser utilizada para avaliar a modulação do SNA sob condições fisiológicas, tais como em situações de vigília e sono, diferentes posições do corpo, treinamento físico, e também em condições patológicas. Mudanças nos padrões da VFC fornecem um indicador sensível e antecipado de comprometimentos na

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“…Some respiratory maneuvers may lead to an overload of this system, thereby activating arterial baroreceptors, chemoreceptors and cardiopulmonary receptors that are linked to the central nervous system. This leads to responses caused by the activation of the autonomic nervous system, which regulates heart rate (HR) and blood pressure (BP) [10][11][12][13][14] . Therefore, in addition to respiratory responses, PLB may also influence cardiovascular responses, although there is still a lack of studies investigating this topic.…”

Section: Introductionmentioning

confidence: 99%

Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

Ramos

Vanderlei

Ramos

et al. 2009

Rev. bras. fisioter.

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Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD) Influência da respiração freno-labial sobre a variabilidade da frequência cardíaca e parâmetros cardiorrespiratórios em pacientes com doença pulmonar obstrutiva crônica (DPOC) Ramos AbstractObjectives: To assess the effects of pursed-lip breathing (PLB) at rest on the behavior of heart rate (HR) and its variability, and on variations in blood pressure (BP), respiratory rate (RR) and pulse oxygen saturation (SpO 2 ) in subjects with chronic obstructive pulmonary disease (COPD). Methods: Sixteen subjects with COPD (seven in GOLD stage I, three in GOLD stage II and six in GOLD stage III; mean age 64±11 years; mean FEV 1 60±25% of predicted value) were assessed at rest, in a seated position, under the following conditions: ten minutes of normal breathing without PLB (R1), eight minutes with PLB (R2) and ten minutes of normal breathing once more (R3). HR was recorded, beat-to-beat, by means of a Polar S810 heart monitor. The RMSSD index (root mean square of the difference between successive R-R intervals) was determined. BP, RR and SpO 2 were also assessed during the trials. ANOVA for repeated measures followed by the Tukey test and Kruskal-Wallis test were used for data analysis, with a 5% significance level. Results: There was a significant increase in the RMSSD index during R2, in comparison with R1. The HR variation between inspiration and expiration was 8.98 bpm, and the variation between HR at rest and HR with PLB was 8.25 bpm. During R2, RR decreased and SpO 2 increased significantly in comparison with R1 and R3. BP values did not show significant changes. Conclusions: The results showed that PLB produced significant changes in HR, RR and SpO 2 , and did not alter BP in subjects with COPD. Furthermore, analysis of the RMSSD index showed that PLB promoted increased parasympathetic activity in these subjects, thus indicating that this technique influenced the autonomic cardiac modulation.Key words: Chronic obstructive pulmonary disease; pursed-lip breathing; heart rate variability. ResumoObjetivos: Avaliar os efeitos da respiração freno-labial (RFL), em repouso, sobre o comportamento da frequência cardíaca (FC) e sua variabilidade e variações na pressão arterial (PA), frequência respiratória (FR) e saturação parcial de oxigênio (SpO 2 ) em pacientes com doença pulmonar obstrutiva crônica (DPOC). Métodos: Dezesseis pacientes com DPOC (7: estágio GOLD I, 3: estágio GOLD II e 6: estágio GOLD III; média de idade=64±11; média de VEF 1 =60±25% do predito) foram avaliados em repouso, na posição sentada, nas seguintes condições: 10 minutos respirando normalmente sem RFL (R1), 8 minutos com RFL (R2) e 10 minutos respirando novamente normalmente (R3 Os resultados mostraram que a RFL produziu modificações significativas na FC, FR e SpO 2 e não alterou a PA em pacientes com DPOC. Além disso, a análise do índice RMSSD mostrou que a RFL promoveu aumento da atividade para...

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The Control of Breathing in Clinical Practice

Cited by 130 publications

References 95 publications

Measurement Accuracy of Heart Rate and Respiratory Rate during Graded Exercise and Sustained Exercise in the Heat Using the Zephyr BioHarnessTM

Measurement Accuracy of Heart Rate and Respiratory Rate during Graded Exercise and Sustained Exercise in the Heat Using the Zephyr BioHarnessTM

Noções básicas de variabilidade da frequência cardíaca e sua aplicabilidade clínica

Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

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