Lavault Sophie, Niérat Marie-Cécile, Nion Nathalie, Didier Caroline, Serresse Laure, Morélot-Panzini Capucine, Similowski Thomas
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France.
AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, Hôpital Pitié-Salpêtrière, Service de Médecine de Réadaptation Respiratoire (Département R3S), Paris, France.
ERJ Open Res. 2025 Sep 22;11(5). doi: 10.1183/23120541.01342-2024. eCollection 2025 Sep.
Experimentally inducing dyspnoea in healthy volunteers is a powerful research tool. Even though this approach is not considered to carry particular risks, dyspnoea occurs in a general context of stress. We hypothesised that experimental dyspnoea could be traumatic in some individuals, with immediate or delayed adverse psychological reactions.
40 participants (median (interquartile range) age 38.7 (29.7-49.1) years; 20 women) were exposed, in random order, to inspiratory threshold loading (ITL; "excessive breathing effort"; unpleasantness rating 6 (4-7) on a 0-10 scale) and carbon dioxide stimulation with restricted ventilatory response (CO-rv; "air hunger"; unpleasantness rating 7 (7-8)). Participants were evaluated immediately after induced dyspnoea, at 7 days and after a further 3 months.
Peritraumatic Distress Inventory (PDI) scores were higher immediately after CO-rv than after ITL (3 (1-6.5) 2 (0-3); p<0.0001). After 7 days, six participants (15%) had an Impact of Event Scale-Revised (IES-R) score ≥12 (high risk of post-traumatic stress disorder (PTSD)). They had significantly higher baseline anxiety trait indicators than the participants with an IES-R score <12 (baseline Anxiety Sensitivity Index 27.5 (14.75-61.25) 10 (3-19); p=0.0087). At 3 months, no participant had a PTSD Checklist for DSM-5 (PCL-5) score suggestive of PTSD (1 (0-4), range 0-23, threshold 33) but the six participants with IES-R ≥12 on day 7 had significantly higher PCL-5 scores (13.5 (1-21.5) 0 (0-4); p=0.0014).
Although no severe situations were encountered, this study highlights the need for caution when designing experimental dyspnoea studies, particularly when involving individuals with high trait anxiety.
在健康志愿者中通过实验诱导呼吸困难是一种强大的研究工具。尽管这种方法不被认为具有特殊风险，但呼吸困难是在压力的总体背景下发生的。我们假设实验性呼吸困难在某些个体中可能具有创伤性，会引发即时或延迟的不良心理反应。
40名参与者（年龄中位数（四分位间距）为38.7（29.7 - 49.1）岁；20名女性）被随机依次暴露于吸气阈值负荷（ITL；“过度呼吸努力”；在0 - 10分制中的不愉快评分为6（4 - 7））和伴有受限通气反应的二氧化碳刺激（CO - rv；“空气饥饿”；不愉快评分为7（7 - 8））。在诱导呼吸困难后即刻、7天及再过3个月时对参与者进行评估。
创伤期痛苦量表（PDI）得分在CO - rv后即刻高于ITL后（3（1 - 6.5）对2（0 - 3）；p < 0.0001）。7天后，6名参与者（15%）事件影响量表修订版（IES - R）得分≥12（创伤后应激障碍（PTSD）高风险）。他们的基线焦虑特质指标显著高于IES - R得分<12的参与者（基线焦虑敏感性指数为27.5（14.75 - 61.25）对10（3 - 19）；p = 0.0087）。3个月时，没有参与者的DSM - 5创伤后应激障碍检查表（PCL - 5）得分提示患有PTSD（1（0 - 4），范围0 - 23，阈值33），但7天时IES - R≥12的6名参与者的PCL - 5得分显著更高（13.5（1 - 21.5）对0（0 - 4）；p = 0.0014）。
尽管未遇到严重情况，但本研究强调在设计实验性呼吸困难研究时需要谨慎，特别是当涉及特质焦虑高的个体时。
