The Risk of Hospitalization and Near-Fatal and Fatal Asthma in Relation to the Perception of Dyspnea

Magadle, Rasmi; Berar-Yanay, Noa; Weiner, Paul S.; Cydulka, R.K.

doi:10.1016/s0196-0644(03)90205-1

Cited by 45 publications

(68 citation statements)

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“…Although it is possible that the degree of physiological deficit in some of these patients may not have been clinically significant enough for them all to have symptoms at rest, not all patients with asthma who have deficits in lung function appreciate the degree to which their asthma contributes to symptoms of airflow limitation until they are given bronchodilators, with resultant improvement in lung function and symptoms. [1][2][3][4] In our study, active bronchodilator resulted in a substantial improvement in lung function as compared with no treatment control (20.1% vs.…”

Section: Irccs Burlo Garofolo University Trieste Italysupporting

confidence: 45%

Placebo and Other Interventions in Asthma

Straumann¹,

Safroneeva²,

Schoepfer³

2011

N Engl J Med

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Section: Irccs Burlo Garofolo University Trieste Italysupporting

confidence: 45%

Placebo and Other Interventions in Asthma

Straumann¹,

Safroneeva²,

Schoepfer³

2011

N Engl J Med

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“…According to one study, around 26% of patients with asthma have abnormally low perceptions of dyspnoea [51]; this was associated with low consumption of medication, increased emergency department visits, hospitalizations, near-fatal asthma attacks, and deaths during follow-up [51]. A second study confirmed the association between near fatal asthma and low perceptions of dyspnoea, as well as blunted hypoxic sensitivity [52].…”

Section: Asthmamentioning

confidence: 96%

The role of inspiratory muscle function and training in the genesis of dyspnoea in asthma and COPD

McConnell

2005

Primary Care Respiratory Journal

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SummaryThe cardinal symptom of both asthma and COPD is dyspnoea, and from a patient perspective, the most troublesome. There are a multitude of inputs to the sensation of dyspnoea, few of which are readily modifiable. The level of inspiratory muscle work contributes to the sense of respiratory muscle effort and thence dyspnoea. Inspiratory muscle work is elevated in patients with COPD and asthma due to hyperinflation and an increased ventilatory requirement for exercise. Treatment tends to concentrate on reducing the load upon the inspiratory muscles induced by hyperinflation. Bronchodilators are the mainstay of treatment for COPD and asthma; they reduce hyperinflation, inspiratory muscle loading and dyspnoea. In addition, programmes of pulmonary rehabilitation have an excellent evidence base for improving dyspnoea, exercise tolerance and quality of life. However, provision within the NHS is limited and not all patients are suitable. One component of pulmonary rehabilitation that can be implemented safely in a home-based setting is specific inspiratory muscle training (IMT). There is a strong theoretical rationale for IMT in patients with airway obstruction, which is also supported by empirical evidence. IMT offers a relatively accessible non-pharmacological treatment for dyspnoea that also improves exercise tolerance and quality of life.

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“…335 A minority of patients may perceive symptoms poorly and experience a significant decline in lung function without a perceptible change in symptoms. 108,109,117 This situation especially affects patients with a history of near-fatal asthma and also appears to be more common in males.…”

Section: Diagnosis Of Exacerbationsmentioning

confidence: 99%