Ventilatory responses to exercise in humans lacking ventilatory chemosensitivity.

Shea, Steven A.; Andrés, Leire; Shannon, Daniel C.; Banzett, Robert B.

doi:10.1113/jphysiol.1993.sp019792

Cited by 119 publications

(76 citation statements)

References 19 publications

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“…32,34,35 Air hunger is hypothesized to arise from corollary discharge from the medullary respiratory center as the afferent stimulus. 36,37 All subjects in the current study were free of cardiovascular or respiratory disease; thus, the low frequency of these dyspnea clusters is in agreement with previous fi ndings in these patient populations 9,10 and increases our confi dence in the validity of the questionnaire. In addition, the RPB 5 3 group responses for most clusters fell between the 1 DOE and the 2 DOE group responses, which also indicates that the questionnaire can be used reliably to assess respiratory sensations.…”

Section: Quality Of Respiratory Sensations During Constant-load 60-w supporting

confidence: 78%

Respiratory Symptom Perception Differs in Obese Women With Strong or Mild Breathlessness During Constant-Load Exercise

Bernhardt

Babb

2014

Chest

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responses. 1,2 Dyspnea on exertion (DOE) is a very common symptom in obesity. 3 In one large epidemiologic survey, 80% of obese adults reported breathlessness after climbing two fl ights of stairs compared with 16% of nonobese control subjects. 4 Another survey (N 5 16,692) found that 36% of obese adults experienced dyspnea when walking up a hill. 5 Our laboratory D yspnea is defi ned as a subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity; these sensations originate from interactions among multiple physiologic, psychologic, social, and environmental factors and may induce secondary physiologic and behavioral Background: During constant-load exercise, some otherwise healthy obese women report substantially more dyspnea on exertion (DOE) than do others. The objective of this study was to investigate whether qualitative differences exist between the sensations of dyspnea felt by these women. Methods: Seventy-eight women were categorized based on their ratings of perceived breathlessness (RPBs) (Borg 0-10 scale) after 6 min of 60-W cycling. Thirty-four women rated RPB Ն 4 ( 1 DOE) (34 Ϯ 7 years, 36 Ϯ 5 kg/m 2 BMI), and 22 women rated RPB Յ 2 ( 2 DOE) (32 Ϯ 7 years, 37 Ϯ 4 kg/m 2 BMI). Twenty-two women rated RPB as 3 (RPB 5 3) (34 Ϯ 7 years, 34 Ϯ 4 kg/m 2 BMI) and were grouped separately to allow for a better delineation of the 1 DOE and the 2 DOE groups. After the exercise test, subjects were asked to pick three of 15 statements that best described their respiratory sensations. Results: The 1 DOE and the 2 DOE groups were characterized differentially ( P , .05) by the respiratory clusters "Breathing more" (82% of 2 DOE vs 41% of 1 DOE), "Shallow" (36% vs 6%), and "Heavy" (14% vs 53%). All four descriptors in the cluster "Work/Effort" were chosen more frequently by women in the 1 DOE group than by women in the 2 DOE group. Although relative exercise intensity was higher in the 1 DOE women (75% Ϯ 13% vs 67% Ϯ 10% of oxygen uptake at peak exercise, 41 Ϯ 10 L/min vs 31 Ϯ 8 L/min as % maximal voluntary ventilation, 83% Ϯ 7% vs 76% Ϯ 7% of peak heart rate), none of these variables was signifi cantly associated with RPB. Conclusions: Not only is the intensity of dyspnea signifi cantly different between the 1 DOE and the 2 DOE groups, but so are the self-reported qualitative aspects of their dyspnea. Women in the 1 DOE group reported an increased sensation of the work of breathing relative to women in the 2 DOE group, which may be associated with the elevated RPB.CHEST 2014; 145(2):361-369Abbreviations: DOE 5 dyspnea on exertion; HR 5 heart rate; MVV 5 maximal voluntary ventilation; RPB 5 rating of perceived breathlessness; co 2 5 CO 2 output; e 5 minute ventilation; o 2 5 oxygen uptake; o 2 peak 5 oxygen uptake at peak exercise; V t 5 tidal volume

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Section: Quality Of Respiratory Sensations During Constant-load 60-w supporting

confidence: 78%

Respiratory Symptom Perception Differs in Obese Women With Strong or Mild Breathlessness During Constant-Load Exercise

Bernhardt

Babb

2014

Chest

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“…reduced V9E-V9CO 2 slope) with CO 2 retention in the absence of a recognisable pulmonary disease [44][45][46]. Secondary hypoventilation is frequently observed in COPD [19,32], and may also be seen in advanced ILD [20] and neuromuscular diseases [47].…”

Section: Abnormal Ventilatory Controlmentioning

confidence: 99%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

Eur Respir J

562

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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“…Rather, there was a slow return to the baseline level. This is in contrast to adults (Beaver andWasserman 1968, 1970;Jeyaranjan et al 1988;Mateika and Duffin 1992) and older children (Shea et al 1993) who show a rapid drop in breathing frequency at the end of exercise, followed by a slower exponential return to resting levels. The possible reasons for this difference are many.…”

Section: Change In the Breathing Frequency At The End Of Steppingmentioning

confidence: 67%

“…School-aged children Ն7 yr of age show a rapid change in breathing frequency (Sato et al 2000;Shea et al 1993) and oxygen consumption (Cooper et al 1985;Hebestreit et al 1998) analogous to that seen in adults. Moreover, passive movement of the lower or upper limbs also induces changes in respiratory rate in children just as in adults FIG. 4.…”

Section: Change In Frequency Of Breathing Occurs At the Beginning Of mentioning

confidence: 99%

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Breathing Frequency Changes at the Onset of Stepping in Human Infants

Noah¹,

Boliek²,

Lam³

et al. 2008

Journal of Neurophysiology

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Breathing frequency increases at the onset of movement in a wide rage of mammals including adult humans. Moreover, the magnitude of increase in the rate of breathing appears related to the rate of the rhythmic movement. We determined whether human infants show the same type of response when supported to step on a treadmill. Twenty infants (ages 9.7 Ϯ 1.2 mo) participated in trials consisting of sitting, stepping on the treadmill, followed by sitting again. Breathing frequency was recorded with a thermocouple, positioned under one naris and taped to a soother that the infant held in his/her mouth. A video camera, electrogoniometers, and force platforms under the treadmill belts recorded stepping movements. We found that the rate of breathing changed at the beginning of stepping. Most surprisingly, we found that when infants stepped at a frequency slower than their breathing frequency in sitting, the breathing frequency decreased. Average breathing frequency during stepping was positively correlated with stepping frequency. There was no evidence of entrainment between stepping and breathing. In conclusion, the rapid change in breathing frequency at the beginning of movement is functional in infants. The direction and magnitude of change in breathing is associated with the leg movements.

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Ventilatory responses to exercise in humans lacking ventilatory chemosensitivity.

Cited by 119 publications

References 19 publications

Respiratory Symptom Perception Differs in Obese Women With Strong or Mild Breathlessness During Constant-Load Exercise

Respiratory Symptom Perception Differs in Obese Women With Strong or Mild Breathlessness During Constant-Load Exercise

Recommendations on the use of exercise testing in clinical practice

Breathing Frequency Changes at the Onset of Stepping in Human Infants

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