Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Vancouver, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, Canada; School of Kinesiology, University of British Columbia, Vancouver, Canada.
Respir Physiol Neurobiol. 2019 Aug;266:1-8. doi: 10.1016/j.resp.2019.04.004. Epub 2019 Apr 12.
Unsatisfied inspiration is commonly reported during exercise by patients with interstitial lung disease (ILD). However, the physiological basis of perceived dyspnea quality in this population has not been evaluated. We examined the relationship between dyspnea quality and indices of ventilatory-mechanical limitations during exercise in patients with fibrotic ILD. Sixteen fibrotic ILD patients (12 male) with a median age of 64 years (range 49-81), FVC 71%-predicted (51-100), and DL 47%-predicted (27-77) performed incremental and constant work-rate cycle exercise tests to exhaustion. Ventilatory responses were recorded at rest, throughout exercise, and at peak exercise. Dyspnea quality was serially assessed using a 4-item list from which participants selected the phrase that best described their breathing compared to rest. Increased work/effort was the dominant descriptor of dyspnea throughout exercise, but with increased selection of unsatisfied inspiration following the inflection point of tidal volume relative to ventilation. Delaying or preventing ILD patients from reaching a critically reduced IRV may have implications for symptom management.
间质性肺疾病（ILD）患者在运动时常报告吸气不足，但尚未对其呼吸困难质量的生理学基础进行评估。我们研究了纤维化 ILD 患者运动期间呼吸困难质量与通气-力学限制指标之间的关系。16 名纤维化 ILD 患者（男 12 名），中位年龄 64 岁（范围 49-81），FVC 预测值的 71%（51-100），DL 预测值的 47%（27-77），进行递增和恒功速率的运动试验直至力竭。在休息、运动全过程和运动峰值时记录通气反应。使用 4 项清单对呼吸困难质量进行连续评估，参与者从中选择最能描述其与休息时相比的呼吸的短语。在运动过程中，增加工作/努力是呼吸困难的主要描述词，但在潮气量相对于通气的拐点之后，吸气不足的选择增加。延迟或阻止ILD 患者达到严重降低的 IRV 可能会对症状管理产生影响。
