Dyspnoea: a multidimensional and multidisciplinary approach

Laviolette, Louis; Laveneziana, Pierantonio

doi:10.1183/09031936.00092613

Cited by 242 publications

(230 citation statements)

References 149 publications

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“…3 There are solid evidences showing that these respiratory sensations may consist of qualitatively distinct neurophysiological mechanisms. 4 Work/effort may be originated from increased respiratory motor command. In addition, it has been reported that air hunger may derive from increased central chemoreceptors that are stimulated by hypercapnia.…”

Section: The Definition and Sensory Quality Of Dyspneamentioning

confidence: 99%

“…12 Therefore, recent studies emphasized that multidimensional nature of dyspnea in the sensory-perceptual (intensity and quality) are effective against distress and impact domains. 4 In multidimensional ratings to measure dyspnea, there are currently three available methods that consist of Multidimensional Dyspnea Profile (MDP), 13 Dyspnea-12 (D-12) 14 and Cancer Dyspnea Scale. 15 The MDP evaluates dyspnea during a specific time or a particular activity and is designed to examine individual items.…”

Section: Multidimensional Approaches To Assess Dyspneamentioning

confidence: 99%

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Recent Advances in Assessment of Dyspnea

Kanezaki¹

2017

Pulm Res Respir Med Open J

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As pulmonary rehabilitation can provide various benefits on managing the symptoms of dyspnea, alleviating dyspnea represents a major goal in pulmonary rehabilitation. Dyspnea appears not to be just a single sensation, as it includes the three sensory quality of dyspnea; work/effort, air-hunger and chest tightness. In addition to sensation of dyspnea, complex emotions including anxiety, attention and fear can involve through processing of the limbic system. Recent studies emphasized the multidimensional nature of dyspnea in the sensory-perceptual (intensity and quality), affective distress and impact domains. This review focused on the underlying mechanism of dyspnea and recent advances in assessment in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD).

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Section: The Definition and Sensory Quality Of Dyspneamentioning

confidence: 99%

Section: Multidimensional Approaches To Assess Dyspneamentioning

confidence: 99%

Recent Advances in Assessment of Dyspnea

Kanezaki¹

2017

Pulm Res Respir Med Open J

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“…It is the third leading cause of mortality worldwide and associated with significant individual and socioeconomic burden [1,3,4]. Dyspnea is the highly aversive cardinal symptom of COPD and causing significant reductions in patients activity levels and quality of life [1,5,6]. In fact, dyspnea is an important predictor of mortality in COPD with greater predictive value than spirometric lung function measures [7,8].…”

Section: Introductionmentioning

confidence: 99%

Validity of a Self-administered Questionnaire Version of the Transition Dyspnea Index in Patients with COPD

Leupoldt

Reijnders

Schüler

et al. 2016

COPD: Journal of Chronic Obstructive Pulmonary Disease

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The transition dyspnea index (TDI) is among the most widely used instruments in COPD patients to measure changes in dyspnea over time. In its original version it is used as guideline for a structured interview to assess the impact of daily activities on dyspnea in the three subdomains functional impairment, magnitude of task, and magnitude of effort. However, the TDI is sometimes used as a self-administered paper-and-pencil questionnaire. The validity of this questionnaire format has not been tested, which was the aim of the present study.We tested 190 patients with COPD at start and end of a 3-week inpatient pulmonary rehabilitation program (PR). Dyspnea was assessed with the modified Medical Research Council Scale (mMRC), a questionnaire version of the TDI, and an interview version of the TDI.Group means for the TDI questionnaire and interview version were widely comparable for the TDI summary score and the three TDI subdomains. The scores of both TDI versions were strongly correlated and showed comparable, but only weak, correlations with changes during PR in spirometric lung function and mMRC. Improvement in dyspnea after PR was observed in 89% of patients when using the summary score of the questionnaire TDI, but only in 34% of patients when using the mMRC.The results suggest that a self-administered questionnaire format of the TDI is an adequate instrument for assessing changes in activity-related dyspnea during PR in patients with COPD. The responsiveness of this instrument to effects of PR appears greater than the responsiveness of the mMRC.3

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“…The most frequent subtypes of dyspnoea (and associated descriptors used by patients) are: 1) work/effort ("breathing requires work or effort"); 2) tightness ("chest is constricted, chest feels tight"); and 3) air hunger/unsatisfied inspiration ("starved for air, urge to breathe, like breath holding"). It is generally accepted that these sensations do not share the same physiological mechanisms [1,5]. Some of these sensations, such as work/effort and air hunger/ unsatisfied inspiration may coexist and vary independently in the same subject or experimental condition.…”

mentioning

confidence: 99%

“…Of note, data from investigations utilising three-dimensional brain-imaging technology have demonstrated that dyspnoea activates cortico-limbic structures that also subserve interoceptive awareness and nociceptive sensations such as pain. Opioids, both endogenous and exogenous, may relieve dyspnoea by altering central processing of efferent and afferent sensory information [1,5].…”

mentioning

confidence: 99%