Decavèle Maxens, Nierat Marie-Cécile, Laviolette Louis, Wattiez Nicolas, Bachasson Damien, Kemoun Gabriel, Morélot-Panzini Capucine, Demoule Alexandre, Similowski Thomas
APHP Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Et Clinique, 47-83 Boulevard de L'Hôpital, 75013, Paris, France.
Service de Médecine Intensive Et Réanimation (Département R3S), Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, 75013, Paris, France.
Eur J Appl Physiol. 2025 Mar;125(3):729-737. doi: 10.1007/s00421-024-05627-8. Epub 2024 Oct 10.
Dyspnea is associated with fear and intense suffering and is often assessed using visual analog scales (VAS) or numerical rating scales (NRS). However, the physiological correlates of such ratings are not well known. Using the voluntary breath-holding model of induced dyspnea, we studied healthy volunteers to investigate the temporal relationship between dyspnea, the neural drive to breathe assessed in terms of involuntary thoracoabdominal movements (ITMs) and neurovegetative responses.
Twenty-three participants (10 men; median [interquartile range] age 21 [20-21]) performed three consecutive breath-holds with the continuous assessment of dyspnea (urge-to-breathe) using a 10 cm VAS, thoracic and abdominal circumferences measured with piezoelectric belt-mounted transducers, heart rate and heart rate variability (HRV), and galvanic skin response (GSR). Urge-to-breathe VAS at the onset of ITMs (gasping point) was identified visually or algorithmically.
Urge-to-breathe VAS at the end of the breath-hold was 9.7 [8.6-10] cm. Total breath-hold duration was 93 [69-130] s. Urge-to-breathe VAS, ITM, heart rate, HRV, and GSR significantly increased during breath-hold. Urge-to-breathe VAS correlated with the magnitude of the thoracic and abdominal movements (rho = 0.51 and rho = 0.59, respectively, p < 0.001). The urge-to-breathe ratings corresponding with ITM onset were 3.0 [2.0-4.7] cm and 3.0 [1.0-4.0] cm for visual and algorithmic detection, respectively (p = 0.782).
An urge-to-breathe VAS of 3 cm (30% of full scale on a 10 cm VAS) corresponds to a physiological turning point during the physiological response to voluntary breath-holding in healthy humans.
呼吸困难与恐惧和强烈痛苦相关，常使用视觉模拟量表（VAS）或数字评定量表（NRS）进行评估。然而，此类评定的生理相关性尚不明确。我们利用诱发呼吸困难的自主屏气模型，对健康志愿者进行研究，以探讨呼吸困难、以不自主胸腹运动（ITM）评估的呼吸神经驱动和神经植物性反应之间的时间关系。
23名参与者（10名男性；年龄中位数[四分位间距]为21[20 - 21]岁）连续进行三次屏气，同时使用10厘米的VAS持续评估呼吸困难（呼吸冲动），通过安装在皮带上的压电换能器测量胸廓和腹部周长、心率和心率变异性（HRV）以及皮肤电反应（GSR）。通过视觉或算法确定ITM（喘息点）开始时的呼吸冲动VAS。
屏气结束时的呼吸冲动VAS为9.7[8.6 - 10]厘米。总屏气持续时间为93[69 - 130]秒。屏气过程中，呼吸冲动VAS、ITM、心率、HRV和GSR显著增加。呼吸冲动VAS与胸廓和腹部运动幅度相关（rho分别为0.51和0.59，p < 0.001）。视觉检测和算法检测时，与ITM开始对应的呼吸冲动评定分别为3.0[2.0 - 4.7]厘米和3.0[1.0 - 4.0]厘米（p = 0.782）。
在健康人自主屏气的生理反应过程中，3厘米的呼吸冲动VAS（10厘米VAS满量程的30%）对应一个生理转折点。
