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- Title
Chronic Exertional Dyspnea and Respiratory Muscle Function in Patients with Chronic Obstructive Pulmonary Disease.
- Authors
Ferrari, K.; Goti, P.; Misuri, G.; Amendola, M.; Rosi, E.; Grazzini, M.; Iandelli, I.; Duranti, R.; Scano, G.
- Abstract
The symptom of breathlessness is an important outcome measure in the management of patients with chronic obstructive pulmonary disease (COPD). Clinical ratings of dyspnea and routine lung function are weakly related to each other. However, in the clinical setting breathlessness in COPD is encountered under conditions of increased respiratory effort, impeded respiratory muscle action, or functional weakness. Thus, the present study was carried out to determine whether and to what extent clinical ratings of dyspnea and respiratory muscle dysfunction relate to each other. In 21 patients with COPD two methods were used to rate dyspnea: a modified Medical Research Council Scale (MRC) and the Baseline Dyspnea Index (BDI), which is a multidimensional instrument for measuring dyspnea based on three components: magnitude of task, magnitude of effort, and functional impairment. A baseline focal score was obtained as the sum of the three components. Measures were: pulmonary volumes; arterial blood gases; maximal voluntary ventilation (MVV); maximal inspiratory and expiratory pressures (MIP and MEP, respectively); and breathing patterns ventilation (V[subE]), tidal volume (V[subT]), and respiratory frequency (Rƒ ). In 15 patients pleural pressure was also measured during both quiet breathing (Ppl[subsw] ) and maximal inspiratory sniff maneuver at FRC (Pplsn). BDI and MRC ratings related to each other and showed comparable weak associations with standard parameters (FEV [sub1] ,PaCO[sub2 ], V[subT]), MIP, and MEP. In contrast, MVV closely and similarly related to both ratings. Ppl[subsw] (%Ppl[subsn] ), a measure of respiratory effort, and Ppl[subsw] (%Ppl[subsn] )/V [subT] (%VC), an index of neuroventilatory dissociation, related significantly to both the BDI (r² = -0.77 and r ² = -0.75, respectively) and the MRC (r² = 0.81 and r² = 0.74, respectively). Using MVV, Ppl[subsw] (%Ppl[subsn] ), and Ppl[subsw] (%Ppl[subsn] )/V[subT ]..
- Subjects
DYSPNEA; RESPIRATORY muscles; LUNG diseases
- Publication
Lung, 1997, Vol 175, Issue 5, p311
- ISSN
0341-2040
- Publication type
Article
- DOI
10.1007/PL00007577