Effects of changes in level and pattern of breathing on the sensation of dyspnea

Breathing during hypercapnia is determined by reflex mechanisms but may also be influenced by respiratory sensations. The present study examined the effects of voluntary changes in level and pattern of breathing on the sensation of dyspnea at a constant level of chemical drive. Studies were carried out in 15 normal male subjects during steady-state hypercapnia at an end-tidal PCO2 of 50 Torr. The intensity of dyspnea was rated on a Borg category scale. In one experiment (n = 8), the level of ventilation was increased or decreased from the spontaneously adopted level (Vspont). In another experiment (n = 9), the minute ventilation was maintained at the level spontaneously adopted at PCO2 of 50 Torr and breathing frequency was increased or decreased from the spontaneously adopted level (fspont) with reciprocal changes in tidal volume. The intensity of dyspnea (expressed as percentage of the spontaneous breathing level) correlated with ventilation (% Vspont) negatively at levels below Vspont (r = -0.70, P less than 0.001) and positively above Vspont (r = 0.80, P less than 0.001). At a constant level of ventilation, the intensity of dyspnea correlated with breathing frequency (% fspont) negatively at levels below fspont (r = -0.69, P less than 0.001) and positively at levels above fspont (r = 0.75, P less than 0.001). These results indicate that dyspnea intensifies when the level or pattern of breathing is voluntarily changed from the spontaneously adopted level. This is consistent with the possibility that ventilatory responses to changes in chemical drive may be regulated in part to minimize the sensations of respiratory effort and discomfort.     

Total respiratory tract deposition of fine micrometer-sized particles in healthy adults: empirical equations for sex and breathing pattern.

Accurate dose estimation under various inhalation conditions is important for assessing both the potential health effects of pollutant particles and the therapeutic efficacy of medicinal aerosols. We measured total deposition fraction (TDF) of monodisperse micrometer-sized particles [particle diameter (Dp) = 1, 3, and 5 microm in diameter] in healthy adults (8 men and 7 women) in a wide range of breathing patterns; tidal volumes (Vt) of 350-1500 ml and respiratory flow rates (Q) of 175-1,000 ml/s. The subject inhaled test aerosols for 10-20 breaths with each of the prescribed breathing patterns, and TDF was obtained by monitoring inhaled and exhaled aerosols breath by breath by a laser aerosol photometer. Results show that TDF varied from 0.12-0.25, 0.26-0.68, and 0.45-0.83 for Dp = 1, 3, and 5 microm, respectively, depending on the breathing pattern used. TDF was comparable between men and women for Dp = 1 microm but was greater in women than men for Dp = 3 and 5 microm for all breathing patterns used (P < 0.05). TDF increased with an increase in Vt regardless of Dp and Q used. At a fixed Vt TDF decreased with an increase in Q for Dp = 1 and 3 microm but did not show any significant changes for Dp = 5 microm. The varying TDF values, however, could be consolidated by a single composite parameter (omega) consisting of Dp, Vt, and Q. The results indicate that unifying empirical formulas provide a convenient means of assessing deposition dose of particles under varying inhalation conditions.     

Time course of ozone-induced changes in breathing pattern in healthy exercising humans.

We examined the time course of O3-induced changes in breathing pattern in 97 healthy human subjects (70 men and 27 women). One- to five-minute averages of breathing frequency (f(B)) and minute ventilation (Ve) were used to generate plots of cumulative breaths and cumulative exposure volume vs. time and cumulative exposure volume vs. cumulative breaths. Analysis revealed a three-phase response; delay, no response detected; onset, f(B) began to increase; response, f(B) stabilized. Regression analysis was used to identify four parameters: time to onset, number of breaths at onset, cumulative inhaled dose of ozone at onset of O3-induced tachypnea, and the percent change in f(B). The effect of altering O3 concentration, Ve, atropine treatment, and indomethacin treatment were examined. We found that the lower the O3 concentration, the greater the number of breaths at onset of tachypnea at a fixed ventilation, whereas number of breaths at onset of tachypnea remains unchanged when Ve is altered and O3 concentration is fixed. The cumulative inhaled dose of O3 at onset of tachypnea remained constant and showed no relationship with the magnitude of percent change in f(B). Atropine did not affect any of the derived parameters, whereas indomethacin did not affect time to onset, number of breaths at onset, or cumulative inhaled dose of O3 at onset of tachypnea but did attenuate percent change in f(B). The results are discussed in the context of dose response and intrinsic mechanisms of action.     

The association between sleep pattern and nutrients intake pattern in healthy overweight and obese adults

Few studies have investigated the association between sleep pattern and nutrient intake pattern. This study was conducted to examine the associations between patterns of nutrient intake and sleep pattern. 108 overweight and obese individuals were recruited to participate in the present cross-sectional study. Participant underwent sleep evaluation through ActiGraph. A 3-day food dietary record was obtained to estimate food intake for each participant. The average of total sleep duration was 7.07 h, average of wake after sleep onset was 0.43 h, average of sleep latency was 0.14 h, and finally, average of sleep efficacy was 93.66%. Moreover, based on principal component analysis, six nutrient intake patterns were identified: the first and second patterns accounting for 53.88% of the total variance and the third and fourth patterns made up 13.6% of the total variance. Totally, the six patterns constitute 74.8% of the total variance. Our results showed that the second nutrient pattern had a negative correlation with total sleep time (P = 0.03); it was positively correlated with sleep latency (P = 0.004). The sixth nutrient pattern was negatively associated with total sleep time (P = 0.007). It was observed that higher intake of the fourth pattern had a negative correlation with total sleep time (P = 0.03). Higher intake of the fifth pattern was positively associated with sleep latency (P = 0.05). In summary, we found that nutrient patterns are correlated with sleep pattern.

     

Flow-independent nitric oxide exchange parameters in healthy adults.

Currently accepted techniques utilize the plateau concentration of nitric oxide (NO) at a constant exhalation flow rate to characterize NO exchange, which cannot sufficiently distinguish airway and alveolar sources. Using nonlinear least squares regression and a two-compartment model, we recently described a new technique (Tsoukias et al. J Appl Physiol 91: 477-487, 2001), which utilizes a preexpiratory breath hold followed by a decreasing flow rate maneuver, to estimate three flow-independent NO parameters: maximum flux of NO from the airways (J(NO,max), pl/s), diffusing capacity of NO in the airways (D(NO,air), pl x s(-1) x ppb(-1)), and steady-state alveolar concentration (C(alv,ss), ppb). In healthy adults (n = 10), the optimal breath-hold time was 20 s, and the mean (95% intramaneuver, intrasubject, and intrapopulation confidence interval) J(NO,max), D(NO,air), and C(alv,ss) are 640 (26, 20, and 15%) pl/s, 4.2 (168, 87, and 37%) pl x s(-1) x ppb(-1), and 2.5 (81, 59, and 21%) ppb, respectively. J(NO,max) can be estimated with the greatest certainty, and the variability of all the parameters within the population of healthy adults is significant. There is no correlation between the flow-independent NO parameters and forced vital capacity or the ratio of forced expiratory volume in 1 s to forced vital capacity. With the use of these parameters, the two-compartment model can accurately predict experimentally measured plateau NO concentrations at a constant flow rate. We conclude that this new technique is simple to perform and can simultaneously characterize airway and alveolar NO exchange in healthy adults with the use of a single breathing maneuver.     

The effects of breathing pattern training on ventilatory function in patients with COPD

The purpose of this study was to assess the effects of a particular breathing pattern training (BPT) on forced expiratory volume during the first second (FEV₁) and forced vital capacity (FVC) in patients with chronic obstructive pulmonary disease (COPD). The subjects adjusted each breath to a target breath displayed on a video screen, by using visual feedback. This target was chosen in an individual sample recorded at rest. We used a randomized, controlled group design. Twenty patients with stable COPD, FEV₁ less than 1.5 liters, undergoing a traditional rehabilitation program were randomly assigned to the BPT group or to the control group. Each BPT subject underwent 30–35 training sessions spread out over four weeks, in addition to the traditional program. FEV₁ and FVC were performed before and after this program. ANOVAs showed that FEV₁ and FVC significantly improved in BPT subjects, with a mean percent increase of 22% and 19%, respectively. Corresponding changes in controls were not significant. This study showed short-term increases in FEV₁ and FVC in COPD patients practicing BPT in addition to respiratory rehabilitation, in comparison with controls. Further studies should incorporate outcome data to clarify the mechanisms and the duration of this effect.The authors express their gratitude to Philippe Carrias, Elizabeth Maclet, Françoise Tulane, and Bernard Cossalter for their contribution to this study, as well as to Michèle Delaire for her technical assistance.     

Power spectral density of breathing pattern in patients with chronic obstructive lung disease

Newsom Davis and Stagg studying the interrelationship of the volume and time components of individual breaths in healthy resting man described a significant correlation between mean tidal volume (VT) and inspiratory time (TI) r = 0.704. The correlation between mean TI and expiratory time (TE) was lower, r = 0.381. Evaluation of these relationships and of the power spectral density of the breathing pattern was the aim of the present study. For breath by breath analysis we calculated power spectral density and cross correlations of VT, TI and TE. We found a significant correlation between VT and TI in 9 patients with global respiratory insufficiency (RI) (mean r = 0.52) and 7 patients with partial RI (mean r = 0.56). The correlation between TI, TE was lower, in 9 patients with global RI (mean r = 0.21) and 7 patients with partial RI (mean r = 0.35). The results of both groups did not differ from healthy subjects in power spectral density of the breathing pattern and in correlations of VT and TI as well as TI and TE.     

Power spectral density of breathing pattern in patients with pulmonary, heart and liver diseases

Pulmonary functions, breathing pattern and rhythmic oscillations of inspiratory time, expiratory time and tidal volume were studied by calculating autocorrelation functions and power spectral densities in patients with chronic obstructive pulmonary disease and respiratory insufficiency, in patients with cardiac valvular disease and in patients with liver disease at rest. Despite of the pathological results of pulmonary function tests the rhythmic oscillations of inspiratory time, expiratory time and tidal volume were present in all patients and they were intraindividually and interindividually different in the same way as in healthy man.     

关于健康成人左右运动神经传导参数的比较

目的:研究正常人左、右侧的末梢神经传导特点及易损伤性,探讨生活习惯与末梢神经潜在性损伤的内在关联,提高电生理诊断准确率。方法:100名志愿者为对象,检测正中、尺、胫和腓神经的复合肌肉动作电位(CMAP)、F波,观察左、右侧的神经传导参数及左右差值与生活习惯之间的联系。结果:左侧尺、胫运动神经传导速度(MCV)慢于右侧(P值各为0.013、0.011)。MCV≤X-1S尺神经组的远端潜伏期(D Lat)、F波最短潜伏期(F-Lat)延长于MCV>X-1S组(P值均为0.000)。MCV≤X-1S胫神经组的近端波幅(P Amp)低于MCV>X-1S组(P=0.000)。右侧腓神经D Lat延长于左侧(P=0.007),D Lat≥X+1S腓神经组的MCV、F-Lat平均值慢或延长于D Lat相似文献   

正常人年龄与呼吸困难的定量评价研究

呼吸困难是许多临床病人突出的痛苦症状 ,对其客观定量评价是呼吸医学界多年的愿望 ,对正常人呼吸困难感觉状态的认识 ,是认识疾病状态的有效参考。长期以来 ,评价呼吸困难的方法有Ｈｏｕｇｈ Ｊｏｎｅｓ分级、Ｖｉｓｕａｌａｎａｌｏｇｓｃａｌｅ(ＶＡＳ)和Ｂｏｒｇｓｃａｌｅ(ＢＳ)分度等 ,均为定性或半定量方法 ,应用中甚感粗略。近年来 ,有学者发现有些病人运动中ＢＳ与每分钟氧摄取量 (ｏｘｙｇｅｎｕｐｔａｋｅ, ＶＯ2 )直线相关 ,依据回归直线定义了定量评价呼吸困难指标 ,但不同疾病的表现特点及适用范围等尚未定论。本文采用这种定…     

关于健康成人左右运动神经传导参数的比较

目的：研究正常人左、右侧的末梢神经传导特点及易损伤性,探讨生活习惯与末梢神经潜在性损伤的内在关联,提高电生理诊断准确率。方法：100名志愿者为对象,检测正中、尺、胫和腓神经的复合肌肉动作电位（CMAP）、F波,观察左、右侧的神经传导参数及左右差值与生活习惯之间的联系。结果：左侧尺、胫运动神经传导速度（MCV）慢于右侧（P值各为0.013、0.011）。MCV≤X-1S尺神经组的远端潜伏期（D Lat）、F波最短潜伏期（F-Lat）延长于MCV〉X-1S组（P值均为0.000）。MCV≤X-1S胫神经组的近端波幅（P Amp）低于MCV〉X-1S组（P=0.000）。右侧腓神经D Lat延长于左侧（P=0.007）,D Lat≥X＋1S腓神经组的MCV、F-Lat平均值慢或延长于D Lat〈X＋1S组（P值各为0.041、0.000）。结论：左侧尺、胫神经MCV慢于右侧,右侧腓神经D Lat延长于左侧。推测神经传导左右差异是由日常生活中的频繁而反复的轻微外伤导致。     

Anti-bacteroides lipopolysaccharide IgG levels in healthy adults and sepsis patients

Abstract Members of the genus Bacteroides greatly outnumber enterobacteria in the human colon and therefore represent a vast potential pool of biologically active LPS. An enzyme-linked immunosorbent assay was developed to estimate the distribution of IgG levels to LPS from B. fragilis, B. vulgatus, B. thetaiotaomicron and to a mixture of rough LPS from three enterobacteria and Pseudomonas aeruginosa in sera from 641 adult blood donors. By inhibition ELISA some cross-reactivity was demonstrated between the different anti-bacteroides LPS IgG, but with very little between the anti-bacteroides LPS IgG and the anti-enterobacterial/ Pseudomonas LPS IgG. Serum IgG was measured daily over 5–9-day periods in 12 sepsis patients (6 survivors, 6 non-survivors) and in a healthy individual. In all patients IgG levels fluctuated to a greater extent than levels in a healthy subject. Variations all followed similar overall trends and indicated that exposure to bacteroides LPS had occurred. In 5 out of 6 survivors, IgG levels were rising at the end of the period, while 4 of the 6 non-survivors showed falls, with an exception showing increasing levels to B. fragilis LPS. In 5 out of 6 non-survivors, IgG levels against B. fragilis LPS were substantially higher than those against the other LPSs. In this small sample some trends in antibody kinetics have been recognised which suggest bacteroides LPS may be significant in sepsis, and indicate that this study should be extended.     

Mechanisms of exertional dyspnea in patients with cancer.

Exertional dyspnea is an important symptom in cancer patients, and, in many cases, its cause remains unexplained after careful clinical assessment. To determine mechanisms of exertional dyspnea in a variety of cancer types, we evaluated cancer outpatients with clinically important unexplained dyspnea (CD) at rest and during exercise and compared the results with age-, sex-, and cancer stage-matched control cancer (CC) patients and age- and sex-matched healthy control participants (HC). Participants (n = 20/group) were screened to exclude clinical cardiopulmonary disease and then completed dyspnea questionnaires, anthropometric measurements, muscle strength testing, pulmonary function testing, and incremental cardiopulmonary treadmill exercise testing. Dyspnea intensity was greater in the CD group at peak exercise and for a given ventilation and oxygen uptake (P < 0.05). Peak oxygen uptake was reduced in CD compared with HC (P < 0.05), and breathing pattern was more rapid and shallow in CD than in the other groups (P < 0.05). Reduced tidal volume expansion during exercise correlated with reduced inspiratory capacity, which, in turn, correlated with reduced inspiratory muscle strength. Patients with cancer had a relatively reduced diffusing capacity of the lung for carbon monoxide, reduced skeletal muscle strength, and lower ventilatory thresholds during exercise compared with HC (P < 0.05). There were no significant between-group differences in measurements of airway function, pulmonary gas exchange, or cardiovascular function during exercise. In the absence of evidence of airway obstruction or restrictive interstitial lung disease, the shallow breathing pattern suggests ventilatory muscle weakness as one possible explanation for increased dyspnea intensity at a given ventilation in CD patients.     

The investigation of genetic polymorphisms in the carbonic anhydrase VI gene exon 2 and salivary parameters in type 2 diabetic patients and healthy adults

The aim of this study was to investigate carbonic anhydrase (CA) VI Exon 2 single nucleotide polymorphism (SNP) and its possible association with salivary parameters in type 2 diabetic patients compared to healthy adults. Caries status was measured by using the DMFT (number of decayed, missing, and filled teeth) index. Unstimulated whole saliva and blood samples were taken. SNPs of CA gene exon 2 were determined by PCR and DNA sequencing. Salivary CA activity and buffering capacity were determined by the method of Verpoorte and Ericson, respectively. Furthermore, salivary pH was measured with pH paper and salivary flow rate was calculated. Salivary buffering capacity and pH were significantly lower in diabetic patients than those of healthy subjects (P < 0.05). Salivary flow rate, CA activity and DMFT levels did not differ between groups (P > 0.05). Four SNPs were detected; their pubmed database number are rs2274327 (C/T), rs2274328 (A/C), rs2274329 (G/C) and rs2274330. While first three of those were responsible for amino acid changes, the last one was not. The frequencies of SNPs were not significant between groups (P > 0.05). Positive significant correlation was found between CA activity and the frequency of SNPs. There was no correlation between the SNPs frequencies and pH or buffering capacity. SNPs found in this study may be related to salivary CA activity in diabetics.     

Spectral analysis of breathing pattern in man

The periodic oscillations of breathing pattern parameters were studied in 34 healthy subjects. In a three minutes' resting spirometric recording we determined the duration of inspiration, expiration and tidal volume in successive breaths and computed autocorrelation functions and power spectral density. Ten of the subjects were re-examined 2 years later. Pulmonary functions were examined in all of them. Rhythmic changes lasting several respiratory cycles were found in the breathing pattern. Rhythmic changes in the duration of inspiration, expiration and tidal volume differed from one another in the same individual. The spectrograms of the individual breathing pattern parameters in the same individual changed during a 2-year period. Despite individual differences, the power spectral density correlations in the same subject and between different subjects two years later, and the mean curves for power spectral densities, show that in all the subjects the power fell at values of 0 to 0.05 Hz and was then maintained at a roughly constant level. Differences in the spectrograms of the various parameters in the same subject can hardly be attributed to a feedback between peripheral receptors and respiratory centres. Rhythmic changes are probably of central origin.