Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living
Dyspnea affective response: comparing COPD patients with healthy volunteers and laboratory model with activities of daily living
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DOI：
10.1186/1471-2466-13-27
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发表时间：
2013-04-27
影响因子：
3.1
通讯作者：
Banzett, Robert B.
中科院分区：
文献类型：
--
作者：
O'Donnell, Carl R.;Schwartzstein, Richard M.;Banzett, Robert B.
背景资料：健康受试者中实验室诱发的呼吸困难（呼吸不适）被广泛用于研究感知机制，但健康志愿者中实验室诱发的呼吸困难与慢性肺病患者中自发性呼吸困难之间的关系尚未得到很好的确定。我们比较了1）COPD患者与健康志愿者（HV）接受相同实验室刺激时对呼吸困难的情感反应; 2）COPD患者在实验室呼吸困难期间与日常生活活动（ADL）期间对呼吸困难的情感反应。方法：我们通过在限制通气期间增加呼气末CO2（PETCO 2），引起空气饥饿，在13例COPD患者和12例HV中诱导中度和高度呼吸困难水平。我们使用多维呼吸困难特征（MDP）来测量感觉质量的强度（例如，空气饥饿（AH）和工作/努力（W/E））以及即时不适（A（1））和次要情绪（A（2））。10名COPD受试者也完成了MDP实验室外的呼吸困难引起的ADL.Results：COPD患者和HV报告的即时不适感相对于感觉强度相似的水平。COPD患者和HV报告了实验室诱导的呼吸困难期间的焦虑和沮丧;个体间的差异远远超过受试者组间的微小差异。COPD患者在ADL期间与中度实验室呼吸困难期间报告了相似的感觉质量、不适和情绪强度。COPD患者描述限制ADL，以避免更大的呼吸困难。结论：在这项试点研究中，我们没有发现任何证据表明，COPD的历史改变实验室引起的呼吸困难的情感反应，并没有显着差异的情感反应之间的呼吸困难诱发的实验室模型和呼吸困难诱发的ADL。
Background: Laboratory-induced dyspnea (breathing discomfort) in healthy subjects is widely used to study perceptual mechanisms, yet the relationship between laboratory-induced dyspnea in healthy volunteers and spontaneous dyspnea in patients with chronic lung disease is not well established. We compared affective responses to dyspnea 1) in COPD patients vs. healthy volunteers (HV) undergoing the same laboratory stimulus; 2) in COPD during laboratory dyspnea vs. during activities of daily living (ADL).Methods: We induced moderate and high dyspnea levels in 13 COPD patients and 12 HV by increasing end-tidal CO2 (PETCO2) during restricted ventilation, evoking air hunger. We used the multidimensional dyspnea profile (MDP) to measure intensity of sensory qualities (e.g., air hunger (AH) and work/effort (W/E)) as well as immediate discomfort (A(1)) and secondary emotions (A(2)). Ten of the COPD subjects also completed the MDP outside the laboratory following dyspnea evoked by ADL.Results: COPD patients and HV reported similar levels of immediate discomfort relative to sensory intensity. COPD patients and HV reported anxiety and frustration during laboratory-induced dyspnea; variation among individuals far outweighed the small differences between subject groups. COPD patients reported similar intensities of sensory qualities, discomfort, and emotions during ADL vs. during moderate laboratory dyspnea. Patients with COPD described limiting ADL to avoid greater dyspnea.Conclusions: In this pilot study, we found no evidence that a history of COPD alters the affective response to laboratory-induced dyspnea, and no difference in affective response between dyspnea evoked by this laboratory model and dyspnea evoked by ADL.