Mechanisms of Dyspnea

Burki, N. K.; Lee, Lu-Yuan

doi:10.1378/chest.10-0534

Cited by 160 publications

(121 citation statements)

References 53 publications

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“…There is evidence of capacity for direct sensation and perception of CO 2 gas though the trigeminal nerve in rats (Anton et al, 1991), humans (Anton et al, 1992), and chickens (McKeegan et al, 2005), but this has not been examined in pigs. Openmouth breathing is a physiological reaction associated with dyspnea (Burki and Lee, 2010), and has been identified as an indicator of compromised welfare in the pig . It is important to note other researchers have used hyperventilating (Martoft et al, 2002), respiratory distress (Raj and Gregory, 1996) and gasping when describing this behavior.…”

Section: Gas Typementioning

confidence: 99%

Effects of flow rate and gas mixture on the welfare of weaned and neonate pigs during gas euthanasia1

Sadler

Hagen²,

Wang

et al. 2014

Journal of Animal Science

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The objectives of this study were to assess efficacy and welfare implications of gas euthanasia when applied to weaned and neonate pigs. Parameters associated with welfare, which were measured before loss of consciousness, included open-mouth breathing, ataxia, righting response, and escape attempts. Two age groups (weaned and neonate) were assessed in 9 gas treatments arranged in a 2 × 4 factorial design, with 2 gas types (CO 2 = 100% CO 2 and 50:50 = 50:50 CO 2 :argon) and 4 flow rates (box volume exchange/min: slow = 20%; medium = 35%; fast = 50%; prefill = prefilled followed by 20%) and a control treatment in which ambient air was passed through the box. Pig pairs (10/treatment) were placed in a modified Euthanex AgPro system (Euthanex Corp., Palmer, PA). Behavioral and physiological responses were observed directly and from video recordings for latency, duration, prevalence (percent of pigs affected), and frequency (number of occurrences/pig). Data were analyzed as linear mixed models or with a Cox proportional hazard model as appropriate. Piglet pair was the experimental unit. For the weaned pig, welfare was superior with CO 2 relative to 50:50 within 1 or more flow rates on the basis of reduced duration of open-mouth breathing, duration of ataxia, frequency of escape attempts, and duration and frequency of righting response (P < 0.05). No measured parameters indicated superior welfare with the use of 50:50, whereas latencies to loss of posture and last movement favored CO 2 (P < 0.05). Faster flow rates were associated with reduced (P < 0.05) duration or frequency of open-mouth breathing, ataxia, and righting response, as well as superior (P< 0.05) indicators of efficacy, including latencies to loss of posture, gasping, and last movement, relative to slower flow rates. Weaned pigs were more likely to defecate (P < 0.01), display nasal discharge (P < 0.05), and display longer (P < 0.001) latencies to loss of posture and last movement than neonates. Duration of ataxia was the only parameter for which neonates were superior (P < 0.01) to weaned pigs during euthanasia. As such, a 50:50 CO 2 :argon gas mixture and slower flow rates should be avoided when euthanizing weaned or neonate pigs with gas methods. Neonate pigs succumb to the effects of gas euthanasia quicker than weaned pigs and display fewer signs of distress. This is a manuscript of an article that is not peer-reviewed from Journal of Animal Science 92 (2014): 793, doi:10.2527/jas.2013-6598. ABSTRACT:The objectives of this study were to assess efficacy and welfare implications of gas euthanasia when applied to weaned and neonate pigs. Parameters associated with welfare, which were measured prior to loss of consciousness, included open-mouth breathing, ataxia, righting response, and escape attempts. Two age groups (weaned and neonate) were assessed in 9 gas treatments arranged in a 2 × 4 factorial design, with 2 gas types (CO 2 = 100% CO 2 or 50:50 = 50:50 CO 2 :argon) and 4 flow rates (box volume exchange/min: slow = 20%; medium = 35%; fast...

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Section: Gas Typementioning

confidence: 99%

Effects of flow rate and gas mixture on the welfare of weaned and neonate pigs during gas euthanasia1

Sadler

Hagen²,

Wang

et al. 2014

Journal of Animal Science

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“…Studies in humans and experimental animals indicate that adenosine is dyspnogenic and that its effect is mediated by activation of vagal C fibers (16). Most likely based on these observations, a frequently purported, tentative explanation for dyspnea during treatment with ticagrelor is that it may be caused by increased levels of extracellular adenosine.…”

Section: Introductionmentioning

confidence: 99%

“…Recent evidence suggests that a perturbation in the ventilatory response generates afferent information from vagal receptors in the lungs (and possibly mechanoreceptors in the respiratory muscles) to the sensorimotor cortex and results in the sensation of dyspnea (16). Studies in humans and experimental animals indicate that adenosine is dyspnogenic and that its effect is mediated by activation of vagal C fibers (16).…”

Section: Introductionmentioning

confidence: 99%

Why does ticagrelor induce dyspnea?

Cattaneo¹,

Faioni²

2012

Thromb Haemost

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SummaryIn studies that compared the reversible P2Y 12 inhibitor ticagrelor with the irreversible inhibitor clopidogrel, dyspnea was observed more frequently among ticagrelor-treated patients than among clopidogreltreated patients. Because dyspnea was not associated with acidosis, pulmonary or cardiac dysfunction, alterations in the mechanisms and pathways of the sensation of dyspnea may be involved in its pathogenesis. It has been hypothesised that the sensation of dyspnea in ticagrelor-treated patients is triggered by adenosine, because ticagrelor inhibits its clearance, thereby increasing its concentration in the circulation. However, dipyridamole, a much stronger inhibitor of adenosine clearance than ticagrelor, usually does not cause dyspnea. We hypothesise that inhibition of P2Y 12 on sensory neurons increases the sensation of dyspnea, particularly when reversible inhibitors are used. We base our hypothesis on the following considerations: 1) cangrelor and elinogrel, which, like ticagrelor, are reversible P2Y 12 inhibitors, also increase the incidence of dyspnea; 2) it is biologically plausible that inhibition of P2Y 12 on sensory neurons increases the sensation of dyspnea; 3) inhibition of P2Y 12 on platelets (which do not have a nucleus) by clopidogrel is permanent, despite the once daily administration and the short plasma half-life of the inhibitor; 4) in contrast, inhibition of P2Y 12 on neurons by clopidogrel may be temporary and transient, because neurons have a nucleus and can therefore rapidly replace the inhibited receptors with newly synthetised ones; 5) inhibition of P2Y 12 on neurons by reversible inhibitors is permanent, because the plasma drug concentration is maintained high by repeated dosing, in order to ensure permanent inhibition of platelet P2Y 12 .

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“…Musculoskeletal disorders, as well as dyspnea, are among the most common manifestations in patients with chronic obstructive pulmonary disease 1,2 , impacting greatly on the exercise performance capacity 3,4 and muscular strength of these patients [5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Efeitos de um treinamento resistido com tubos elásticos sobre a força muscular, qualidade de vida e dispneia de pacientes com doença pulmonar obstrutiva crônica

et al. 2016

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RESUMOO objetivo deste estudo foi analisar os efeitos do treinamento resistido com tubos elásticos e aparelhos de musculação (convencional) sobre a força muscular, qualidade de vida e dispneia em pacientes com doença pulmonar obstrutiva crônica (DPOC). Pacientes alocados em grupos de treinamento com tubos elásticos (ETG, n=9) e convencional (CRG, n=10) foram avaliados por força isométrica e questionários de qualidade de vida (CRQ) e dispneia (MRC). A força isométrica aumentou em ~25% em ambos os grupos em todos os movimentos (p<0,05). MRC e o domínio dispneia de CRQ apresentaram melhoras de -28,70% e -6,05 % no ETG, e -33,33% e -16,23% no CRG, respectivamente. Força de flexão de ombro e cotovelo apresentaram correlação negativa com a variável MRC (p<0,05) para CRG. Ambas intervenções foram benéficas para aumento da força e redução do MRC, com aumento da força de membros superiores correlacionado à redução da sensação de dispneia nos pacientes com DPOC. Palavras-chave: Exercício. Doença pulmonar obstrutiva crônica. Qualidade de vida. ABSTRACTThe objective of this study was to analyze the effects of resistance training with elastic tubes and weight machines (conventional) on muscle strength, quality of life and dyspnea in patients with chronic obstructive pulmonary disease (COPD). Patients were allocated in training groups with elastic tubes (ETG, n = 9) and conventional (CRG, n = 10) and evaluated by isometric strength and quality of life questionnaire (CRQ) and dyspnea (MRC). Isometric strength increased by ~25% in both groups in all movements (p <0.05). MRC and the CRQ dyspnea domain showed improvement of -28.70% and -6.05% in the ETG, and -33.33% and -16.23% at CRG, respectively. Shoulder and elbow flexion showed a negative and significant correlation with MRC (p <0.05), for CRG. Both interventions were beneficial for increasing the strength and reducing the MRC score, and increased strength of upper limbs correlated to the reduction of the sensation of dyspnea in patients with COPD.

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Mechanisms of Dyspnea

Cited by 160 publications

References 53 publications

Effects of flow rate and gas mixture on the welfare of weaned and neonate pigs during gas euthanasia1

Effects of flow rate and gas mixture on the welfare of weaned and neonate pigs during gas euthanasia1

Why does ticagrelor induce dyspnea?

Efeitos de um treinamento resistido com tubos elásticos sobre a força muscular, qualidade de vida e dispneia de pacientes com doença pulmonar obstrutiva crônica

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