Pathophysiology of Dyspnea in Chronic Obstructive Pulmonary Disease
2012; American Thoracic Society; Linguagem: Inglês
Autores
Denis E. O’Donnell, Robert B. Banzett, Virginia Carrieri‐Kohlman, Richard Casaburi, Paul W. Davenport, Simon C. Gandevia, Arthur F. Gelb, Donald A. Mahler, Katherine A. Webb,
Tópico(s)Music Therapy and Health
ResumoEffective management of dyspnea in chronic obstructive pulmonary disease (COPD) requires a clearer understanding of its underlying mechanisms. This roundtable reviews what is currently known about the neurophysiology of dyspnea with the aim of applying this knowledge to the clinical setting. Dyspnea is not a single sensation, having multiple qualitative descriptors. Primary sources of dyspnea include: (1) inputs from multiple somatic proprioceptive and bronchopulmonary afferents, and (2) centrally generated signals related to inspiratory motor command output or effort. Respiratory disruption that causes a mismatch between medullary respiratory motor discharge and peripheral mechanosensor afferent feedback gives rise to a distressing urge to breathe which is independent of muscular effort. Recent brain imaging studies have shown increased limbic system activation in response to various dyspneogenic stimuli and emphasize the affective dimension of this symptom. All of these mechanisms are likely instrumenta...
Referência(s)