Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome

Hornsveld, Hellen; Garssen, Bart; Dop, M J C Fiedeldij; Spiegel, P.I. van; Haes, J.C.J.M. de

doi:10.1016/s0140-6736(96)02024-7

Cited by 149 publications

(105 citation statements)

References 22 publications

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“…During validation the Nijmegen questionnaire was shown to have a sensitivity of 91% and specificity of 95% [25]. A score of >23 is commonly used as a cut-off for HVS, although this was calculated using a positive hyperventilation provocation test as the gold standard, which itself is no longer considered a reliable way of diagnosing HVS [26]. This test was performed by asking the patient to voluntarily hyperventilate for several minutes and was considered positive if symptoms of HVS were reproducible.…”

Section: Methods Of Assessmentmentioning

confidence: 99%

“…This test was performed by asking the patient to voluntarily hyperventilate for several minutes and was considered positive if symptoms of HVS were reproducible. It was felt these symptoms were due to low end-tidal carbon dioxide, but a study in the Lancet found a high rate of false positives in patients where end-tidal carbon dioxide was controlled via a facemask [26].…”

Section: Methods Of Assessmentmentioning

confidence: 99%

“…Diagnostic criteria initially required the demonstration of hypocapnia and respiratory alkalosis during attacks of hyperventilation. However, more recent research has questioned the importance of hypocapnia in inducing the associated symptoms of HVS as many of these symptoms can occur in normocapnia [26,55,56]. In fact many of the more recent methods used in diagnosis have a poor correlation with carbon dioxide levels [57].…”

Section: Hyperventilation Syndrome and Its Subcategoriesmentioning

confidence: 99%

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Dysfunctional breathing: a review of the literature and proposal for classification

et al. 2016

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Dysfunctional breathing is a term describing breathing disorders where chronic changes in breathing pattern result in dyspnoea and other symptoms in the absence or in excess of the magnitude of physiological respiratory or cardiac disease. We reviewed the literature and propose a classification system for the common dysfunctional breathing patterns described. The literature was searched using the terms: dysfunctional breathing, hyperventilation, Nijmegen questionnaire and thoraco-abdominal asynchrony. We have summarised the presentation, assessment and treatment of dysfunctional breathing, and propose that the following system be used for classification. 1) Hyperventilation syndrome: associated with symptoms both related to respiratory alkalosis and independent of hypocapnia. 2) Periodic deep sighing: frequent sighing with an irregular breathing pattern. 3) Thoracic dominant breathing: can often manifest in somatic disease, if occurring without disease it may be considered dysfunctional and results in dyspnoea. 4) Forced abdominal expiration: these patients utilise inappropriate and excessive abdominal muscle contraction to aid expiration. 5) Thoraco-abdominal asynchrony: where there is delay between rib cage and abdominal contraction resulting in ineffective breathing mechanics.This review highlights the common abnormalities, current diagnostic methods and therapeutic implications in dysfunctional breathing. Future work should aim to further investigate the prevalence, clinical associations and treatment of these presentations. @ERSpublications A review of common abnormalities, current diagnostic methods and therapeutic implications in dysfunctional breathing http://ow.ly/ZTzK6

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Section: Methods Of Assessmentmentioning

confidence: 99%

Section: Methods Of Assessmentmentioning

confidence: 99%

Section: Hyperventilation Syndrome and Its Subcategoriesmentioning

confidence: 99%

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Dysfunctional breathing: a review of the literature and proposal for classification

et al. 2016

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“…In turn physicians may be influenced by the increased expression of symptoms by the patients. As a consequence more anti-inflammatory treatment is prescribed as patients are identified as more acutely ill (Hibbert & Pilsbury, 1988;Hornsveld & Garssen, 1996). The inflammatory marker decreases because it is particularly sensitive to changes in medication, specifically corticosteroids (Chetta et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Psychological Factors in Asthma and Psychoeducational Interventions

Fernandes¹

2012

Allergic Diseases - Highlights in the Clinic, Mechanisms and Treatment

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“…[21][22][23][24] However, in another review article, Gardner argues for the preservation of the term. 25 Other authors have stated that chronic hyperventilation is a common cause of both hyperventilation syndrome and PD.…”

Section: -18mentioning

confidence: 99%

The role of hyperventilation: hypocapnia in the pathomechanism of panic disorder

Sikter¹,

Frecska

Braun

et al. 2007

Rev. Bras. Psiquiatr.

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The role of hyperventilation -hypocapnia in the pathomechanism of panic disorder O papel da hiperventilação -a hipocapnia no patomecanismo do distúrbio de pânico A b s t r a c t Objective: The authors present a profile of panic disorder based on and generalized from the effects of acute and chronic hyperventilation that are characteristic of the respiratory panic disorder subtype. The review presented attempts to integrate three premises: hyperventilation is a physiological response to hypercapnia; hyperventilation can induce panic attacks; chronic hyperventilation is a protective mechanism against panic attacks. Method: A selective review of the literature was made using the Medline database. Reports of the interrelationships among panic disorder, hyperventilation, acidosis, and alkalosis, as well as catecholamine release and sensitivity, were selected. The findings were structured into an integrated model. Discussion: The panic attacks experienced by individuals with panic disorder develop on the basis of metabolic acidosis, which is a compensatory response to chronic hyperventilation. The attacks are triggered by a sudden increase in (pCO 2 ) when the latent (metabolic) acidosis manifests as hypercapnic acidosis. The acidotic condition induces catecholamine release. Sympathicotonia cannot arise during the hypercapnic phase, since low pH decreases catecholamine sensitivity. Catecholamines can provoke panic when hyperventilation causes the hypercapnia to switch to hypocapnic alkalosis (overcompensation) and catecholamine sensitivity begins to increase. Conclusion: Therapeutic approaches should address long-term regulation of the respiratory pattern and elimination of metabolic acidosis.Descriptors: Acidosis; Catecholamines; Hyperventilation; Hypocapnia; Panic disorder Resumo Objetivo: Os autores apresentam um modelo de transtorno do pânico que se baseia nos efeitos da hiperventilação aguda e crônica, característicos do subtipo respiratório de transtorno do pânico. O modelo é generalizado a partir desses efeitos. Ele integra três características da hiperventilação: a hiperventilação é uma resposta fisiológica à hipercapnia; a hiperventilação pode induzir ataques de pânico; a hiperventilação crônica representa um mecanismo protetor contra os ataques de pânico. Método: Revisão seletiva da literatura a partir da base de dados Medline. Foram selecionados relatos referentes à inter-relação entre transtorno do pânico, hiperventilação, acidose, alcalose, liberação de catecolaminas e sensibilidade a catecolaminas, sendo os achados estruturados de modo a formar um modelo integrado. Discussão: Os ataques de pânico do transtorno do pânico desenvolvem-se com base numa acidose metabólica, que é uma resposta compensatória à hiperventilação crônica. Os ataques são desencadeados por um súbito aumento da pressão parcial de dióxido de carbono (pCO 2 ), quando a acidose (metabólica) latente se manifesta pela acidose hipercápnica. A condição acidótica induz liberação de catecolaminas. A simpaticotonia não pode manifestar-se durante...

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Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome

Cited by 149 publications

References 22 publications

Dysfunctional breathing: a review of the literature and proposal for classification

Dysfunctional breathing: a review of the literature and proposal for classification

Psychological Factors in Asthma and Psychoeducational Interventions

The role of hyperventilation: hypocapnia in the pathomechanism of panic disorder

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