Category Archives: Respiratory Symptoms - Part 8

Efficacy of a New Full Face Mask for Noninvasive Positive Pressure Ventilation: Patient Selection

Prior to admission all patients were maximally treated with bronchodilators, supplemental oxygen, and on occasion theophylline for at least 48 h prior to study enrollment. All patients enrolled into the study fulfilled at least two clinical criteria and two physiologic … Continue reading

Efficacy of a New Full Face Mask for Noninvasive Positive Pressure Ventilation

Noninvasive positive pressure ventilation (NPPV) has been shown to be an effective modality for the treatment of chronic respiratory failure in patients with severe restrictive ventilatory disorders’ and in selected patients with chronic obstructive pulmonary diseases. In addition, several recent … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Conclusion

It should be emphasized that CPAP levels should be carefully titrated to the individual patient’s subjective response; levels in excess of the inspiratory threshold load will result in further hyperinflation and attendant potentially deleterious mechanical, hemodynamic, and sensory consequences. Theoretically, … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Mechanical Unloading of Inspiratory Muscles

Opiates and Anxiolytics: Opiates effectively relieve breathlessness in many patients with CAL Postulated mechanisms include reduced motor command output or altered central perception of inspiratory difficulty at a given ventilation. However, serious adverse effects, particularly respiratory depression, preclude their routine … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Anaerobic Threshold

However, reduction of Ve by altering the anaerobic threshold is less consistently achieved in patients with CAL with more advanced disease, where modest improvements in ventilatory reserve are more likely to be attributable to enhanced mechanical efficiency following training. Controlled … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Reducing Ventilatory Demand

Bronchodilator Therapy: As a first step, every effort should be made to reduce the resistive and elastic load on the inspiratory muscles by optimizing bronchodilation. In some instances, adjunct antiinflammatory medication may confer additional benefits. Relief of breathlessness can be … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: The Affective Dimension of Breathlessness

Anxiety or apprehension are almost invariable accompaniments of breathlessness, particularly in patients with advanced disease. Stress and anxiety may of themselves induce breathlessness in CAL or their expression may represent an affective response to the stimulus of perceived inspiratory difficulty. … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Dynamic Lung Hyperinflation in CAL

Effort is generally expressed in physiologic terms as a function of the ratio of esophageal pressure (Pes) to the maximal pressure-generating capacity (Pimax). This ratio correlates strongly with breathlessness. In exercising patients with CAL, resistive loading and particularly acute increases … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Dynamic Lung Hyperinflation in CAL

This result is in accordance with previous studies that have shown that breathlessness increases as the frequency (F) and extent of ventilatory muscle contraction (Vt/VC) increase. The study extended previous observations by underlining the important contribution of acute changes in … Continue reading

Breathlessness in Patients with Chronic Airflow Limitation: Breathlessness

In contrast to normal subjects, EELV in patients with CAL often increases above resting values early in exercise (Fig 1). Acute increases in EELV of 0.31 ±0.55 L and 0.30 ±0.32 L (mean±SD) have been reported with considerable variation noted … Continue reading

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