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Disordered tidal breathing pattern and dyspnoea related disability in Parkinson's disease: A case controlled study 帕金森病潮汐呼吸模式紊乱和呼吸困难相关残疾:一项病例对照研究
IF 1.6 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-07-31 DOI: 10.1016/j.resp.2025.104472
Laura McMahon, Catherine Blake, Olive Lennon

Background

Respiratory dysfunction is a recognised but underexplored feature of Parkinson’s Disease. Understanding underlying mechanisms and their possible impact on breathing patterns is crucial to endeavours to improve respiratory morbidity and mortality associated with Parkinson’s Disease.

Objective

This study explored perceived dyspnoea and resting tidal breathing patterns in Parkinson’s Disease compared to healthy controls.

Methods

Nineteen Parkinson’s Disease participants and 19 age and gender matched controls were recruited. Respiratory assessment included the modified Borg dyspnoea scale, modified Medical Research Council dyspnoea scale, and respiratory inductance plethysmography to measure inspiratory time, expiratory time, total cycle time, respiratory rate, I:E ratio, and thoracic excursion during tidal breathing.

Results

Parkinson’s Disease participants (Hoehn and Yahr stages 1–3; 10 men; 9 women, mean age 65 +/-8years; mean MDS-UPRRS 44.05 +/-18.9) reported significantly greater respiratory disability (modified Medical Research Council) compared to controls (p = 0.005). Dyspnoea rating (modified Borg dyspnoea scale) and disability was significantly greater in the Tremor Dominant group (p < 0.01). Notably, linear mixed models analysing change in breath regularity over time, identified a higher I:E ratio (p = 0.03) and ratio of inspiration to total cycle time (Ti/Ttot) in Parkinson’s Disease participants (p = 0.04), indicating an altered tidal breathing pattern. Thoracic excursion was lower in Parkinson’s Disease participants although differences were non-significant.

Conclusion

Individuals with Parkinson’s Disease experience functional disability related to dyspnoea and altered breathing patterns compared to controls. Further research is warranted with larger numbers to explore these findings across Parkinson’s Disease stages and motor subtypes to develop strategies to improve respiratory health in Parkinson’s Disease.
背景:呼吸功能障碍是帕金森氏病公认但未被充分研究的特征。了解潜在的机制及其对呼吸模式的可能影响对于努力改善与帕金森病相关的呼吸系统发病率和死亡率至关重要。目的:本研究探讨帕金森病患者与健康对照者的感知呼吸困难和静息潮汐呼吸模式。方法:招募了19名帕金森病患者和19名年龄和性别匹配的对照组。呼吸评估包括改进的Borg呼吸困难量表、改进的医学研究委员会呼吸困难量表和呼吸感应体积脉搏图,以测量吸气时间、呼气时间、总周期时间、呼吸频率、I:E比和潮汐呼吸时的胸部运动。结果:帕金森病患者(Hoehn和Yahr期1-3;10人;女性9名,平均年龄65+/-8岁;平均MDS-UPRRS 44.05+/-18.9)报告的呼吸功能障碍明显高于对照组(经修订的医学研究委员会)(p=0.005)。震颤优势组的呼吸困难评分(改进的Borg呼吸困难量表)和残疾显著更高(结论:与对照组相比,帕金森病患者经历与呼吸困难和呼吸模式改变相关的功能残疾)。进一步的研究需要更大的数量来探索帕金森病分期和运动亚型的这些发现,以制定改善帕金森病呼吸健康的策略。
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引用次数: 0
Protective effect of isopimpinellin on ovalbumin-induced airway inflammation and oxidative stress in mouse model of asthma 异opopimpellin对卵清蛋白诱导的哮喘小鼠气道炎症和氧化应激的保护作用
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-07-03 DOI: 10.1016/j.resp.2025.104470
Islam Ahmed Abdelmawgood , Mohamed A. Kotb , Hassan Samy Hassan Eltras , Noha A. Mahana , Lamiaa Goda , Ahmed M. Rochdi , Nader Hassan Sayed , Reem H. Elsafoury , Amal M. Saber , Mahmoud Nabil Youssef , Nancy George Waheeb , Hamid Ashry , Bassam W. Ebeed , Mohamed W.A. Al-Rifai , Abeer Mahmoud Badr , Hadeer Hesham Abdelfattah

Background

Asthma is a chronic airway disease characterized by immunological dysregulation that causes sustained inflammation, leading to aberrant airway narrowing and mucus production. Isopimpinellin (IP) is a naturally occurring furanocoumarin, generated by an association of coumarin and a furan ring, possessing antifungal, antibacterial, and antioxidant properties; however, its potential in asthma treatment has not been investigated. This study sought to evaluate the anti-inflammatory and antioxidant effects of IP in an ovalbumin (OVA)-induced murine model of asthma.

Methods

Mice were grouped into four groups (n = 8 per group): control, OVA, and IP-treated (35 and 70 mg/kg). At the end of the experiment, lung oxidative stress, inflammation, and histopathological changes were evaluated.

Results

IP treatment significantly ameliorated airway oxidative stress by decreasing the concentration of malondialdehyde (MDA) and increasing the levels of antioxidants, including glutathione (GSH), catalase (CAT), and glutathione peroxidase (GPx); reduced inflammatory cell infiltration; mitigated histological changes; and decreased levels of IL-4, IL-13, and IgE. Additionally, IP prevented NF-κB phosphorylation. This study is the first examination of the anti-asthmatic properties of IP in allergic asthma in murine models.

Conclusion

Our data indicate that IP may function as an anti-asthmatic medication via regulating oxidative stress and inflammation.
哮喘是一种慢性气道疾病,其特征是免疫失调,引起持续炎症,导致异常气道狭窄和粘液产生。异opopimpinellin (IP)是一种天然存在的呋喃香豆素,由香豆素和呋喃环结合产生,具有抗真菌、抗菌和抗氧化特性;然而,其在哮喘治疗中的潜力尚未被研究。本研究试图在卵清蛋白(OVA)诱导的哮喘小鼠模型中评估IP的抗炎和抗氧化作用。方法smice分为对照组、OVA组和ip处理组(35和70 mg/kg),每组 = 8只。实验结束时,观察大鼠肺氧化应激、炎症及组织病理学变化。结果sip治疗通过降低丙二醛(MDA)浓度和提高抗氧化剂水平,包括谷胱甘肽(GSH)、过氧化氢酶(CAT)和谷胱甘肽过氧化物酶(GPx),显著改善气道氧化应激;炎症细胞浸润减少;减轻组织学改变;IL-4、IL-13和IgE水平降低。此外,IP阻止NF-κB磷酸化。本研究首次在小鼠变应性哮喘模型中检测了IP的抗哮喘特性。结论黄芪多糖可能通过调节氧化应激和炎症反应发挥抗哮喘作用。
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引用次数: 0
Acrolein-induced oxidative and nitrosative stress and its impact on respiratory mechanics in mice assessed using the forced oscillation technique 用强迫振荡技术评估丙烯醛诱导的氧化和亚硝化应激及其对小鼠呼吸力学的影响
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-06-25 DOI: 10.1016/j.resp.2025.104461
Obada Alfarawati, Bill T. Ameredes
Acrolein exposure in the lung was studied to determine the effect of acrolein on airway responsiveness and pulmonary mechanics, as measured by the forced oscillation technique (FOT), under conditions of airway activation by methacholine (MCh), as well as with no activation, using the negative pressure-driven forced expiratory (NPFE) maneuvers to assess quasi-static lung compliance. Direct intratracheal acrolein was applied to C57BL/6 J male mice in dosages of 0 (saline vehicle-only) or 4 mg/kg, with FOT and NPFE assessments made 48 hr post-acrolein administration. Our results suggest that lipid peroxidation may be a primary factor in the observed attenuated response of resistance of the respiratory system (Rrs) to MCh (25 % decrease), potentially due to the alteration of the lipid bilayer that contains the transmembrane muscarinic receptors that respond to MCh. Furthermore, static lung compliance was significantly reduced in mice receiving acrolein. The product of lipid peroxidation, malondialdehyde (MDA), was confirmed in the bronchoalveolar lavage fluid (BALF) of the acrolein group to be significantly higher than the control groups (35 % increase). The nitrite concentration measured in the acrolein group BALF was consistent with elevated levels of nitric oxide (NO) (∼50 % increase), and perhaps peroxynitrite, which could be additional nitrosative stress factors promoting lipid peroxidation in our acute model of acrolein toxicity. Furthermore, the decrease in glutathione peroxidase (GPx) (52 % decrease) that we observed suggested a significant reduction in endogenous antioxidant capacity, with the oxidative stress associated with increased lipid peroxidation resultant from acrolein exposure. We conclude that the lipid peroxidation and decline in redox capacity due to nitrosative stress induced by acrolein could be an important factor in modulation of pulmonary mechanics, airway remodeling, and bronchial responsiveness.
研究丙烯醛在肺中的暴露,以确定丙烯醛对气道反应性和肺力学的影响,通过强迫振荡技术(FOT)测量,在甲基胆碱(MCh)激活气道的条件下,以及没有激活的情况下,使用负压驱动的强迫呼气(NPFE)机动来评估准静态肺顺应性。以0(纯生理盐水)或4mg/kg剂量直接气管内注射丙烯醛给药C57BL/6J雄性小鼠,并在给药48小时后进行FOT和NPFE评估。我们的研究结果表明,脂质过氧化可能是观察到的呼吸系统(Rrs)对MCh的抗性反应减弱(降低25%)的主要因素,可能是由于含有对MCh有反应的跨膜毒蕈碱受体的脂质双分子层的改变。此外,服用丙烯醛的小鼠的静态肺顺应性显著降低。丙烯醛组支气管肺泡灌洗液(BALF)中脂质过氧化产物丙二醛(MDA)明显高于对照组(增加35%)。丙烯醛组BALF中测量的亚硝酸盐浓度与一氧化氮(NO)水平升高(约50%)一致,可能是过氧亚硝酸盐,这可能是我们急性丙烯醛毒性模型中促进脂质过氧化的额外亚硝化应激因子。此外,我们观察到谷胱甘肽过氧化物酶(GPx)的减少(减少52%)表明内源性抗氧化能力显著降低,氧化应激与丙烯醛暴露导致的脂质过氧化增加有关。我们得出结论,丙烯醛引起的亚硝化应激引起的脂质过氧化和氧化还原能力下降可能是调节肺力学、气道重塑和支气管反应性的重要因素。
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引用次数: 0
The cerebrovascular and executive function responses to increased inspiratory muscle work 脑血管和执行功能对吸气肌工作的增加作出反应
IF 1.6 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-08-11 DOI: 10.1016/j.resp.2025.104473
Edward Bliss , Dean E. Mills
We investigated the cerebrovascular and executive function responses to increased inspiratory muscle work. Eight healthy men (33 ± 6 years) performed two separate 10 min bouts of inspiratory pressure threshold loading (ITL) targeting 70 % of maximal inspiratory mouth pressure (PImax) (ITL-Load) and two separate 10 min bouts of ITL targeting 2 % of PImax (ITL-Control). The order in which each participant undertook ITL-Load and ITL-Control conditions was randomized. Transcranial Doppler ultrasonography was used to measure middle cerebral artery blood velocity (MCAV) and executive function was measured using the trail making task (TMT) Parts A and B during the 4–6th min of ITL-Load and ITL-Control. The cerebrovascular conductance index (CVCi) and cerebrovascular resistance index (CVRi) were calculated. There were time x condition interactions (P < 0.01) for MCAV, CVCi and CVRi. This demonstrated during ITL-Load a small time-dependent increase (P < 0.01) in MCAV and CVCi, and a small time-dependent decrease (P < 0.01) in CVRi. Part A (P = 0.007) and Part B (P = 0.013) times for the TMT were slower for ITL-Load compared to ITL-Control. There were significant correlations between the change in MCAV from rest to the end of ITL and TMT times for Part A (r = 0.81, P = 0.009) and Part B (r = 0.67, P = 0.048). This is the first study to demonstrate that high-intensity ITL results in an increase in MCAV, and a decreased executive function measured by the TMT, and these two measures were related in that the increase in MCAV resulted in slower TMT times.
我们研究了吸气肌功增加时脑血管和执行功能的反应。8名健康男性(33岁 ± ,6岁)分别进行了两次10 min的吸气压力阈值负荷(ITL- load)和两次10 min的吸气压力阈值负荷(ITL- load),目标是最大吸气口压(PImax)的70% % (ITL- control)。每个参与者进行ITL-Load和ITL-Control条件的顺序是随机的。在itl负荷和itl控制的4 ~ 6 min,采用经颅多普勒超声检测大鼠大脑中动脉血流速度(MCAV),并采用轨迹制作任务(TMT) A、B部分检测执行功能。计算脑血管传导指数(CVCi)和脑血管阻力指数(CVRi)。MCAV、CVCi和CVRi存在时间x条件相互作用(P <; 0.01)。这表明在ITL-Load期间,MCAV和CVCi的时间依赖性增加(P <; 0.01),CVRi的时间依赖性减少(P <; 0.01)。实验A部分(P = 0.007)和实验B部分(P = 0.013)对ITL-Load的TMT时间较ITL-Control慢。A组(r = 0.81,P = 0.009)和B组(r = 0.67,P = 0.048)休息至ITL结束时的MCAV变化与TMT次数有显著相关性。这是第一个证明高强度ITL导致MCAV增加和TMT测量的执行功能下降的研究,这两个测量是相关的,因为MCAV的增加导致TMT时间变慢。
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引用次数: 0
Expiratory flow limitation in highly trained endurance athletes: The role of FEF25–75% and ventilatory capacity during treadmill running 高强度耐力运动员的呼气流量限制:在跑步机上跑步时FEF25-75%和通气量的作用。
IF 1.6 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-07-22 DOI: 10.1016/j.resp.2025.104471
A.S. Hind , R.A. Mitchell , J.R. Dunsford , O.N. Ferguson , M. Flynn , S.S. Dhillon , K. Badra , M.S. Koehle , K.M. Milne , J.A. Guenette

Background

Expiratory flow limitation (EFL) during exercise in highly trained individuals is thought to result from increased ventilatory demands that exceed the capacity of the respiratory system, which does not fully adapt to exercise training. Reduced forced expiratory flow between 25 % and 75 % of forced vital capacity (FEF25–75 %), a marker of small airway function, may contribute to EFL by limiting the maximum expiratory flows available during the hyperpnea of exercise. This study investigated whether FEF25–75 %, peak minute ventilation (V̇E), and breathing patterns differ between highly trained endurance athletes with and without EFL.

Methods

Forty highly trained endurance athletes (20 males and 20 females; V̇O2max: 59.6 ± 9.2 mL∙kg−1∙min−1) completed spirometry and a maximal incremental cardiopulmonary treadmill exercise test. EFL was assessed by superimposing tidal flow-volume loops within the maximum flow-volume loop according to end-expiratory lung volume.

Results

During maximal exercise, 40 % of participants (n = 16: 7 males, 9 females) developed EFL, with no significant sex differences (P > 0.05). Athletes with EFL had significantly lower FEF25–75 % (3.45 ± 0.78 vs. 4.16 ± 0.98 L·s−1, P = 0.020, d = 0.802) and a higher ventilatory demand-to-capacity ratio (V̇E/V̇Ecap) (0.86 ± 0.14 vs. 0.66 ± 0.11, P = 0.002, d = 1.589) compared to those without EFL. There were no significant differences in absolute tidal volume, breathing frequency or V̇E between groups (P > 0.05).

Conclusion

In a homogeneous cohort of highly trained endurance athletes, EFL during maximal treadmill exercise appears to be primarily driven by a reduced capacity to generate expiratory flow, as evidenced by lower FEF25–75 %, rather than differences in ventilatory demand.
背景:高度训练的个体在运动期间的呼气流量限制(EFL)被认为是由于通气需求增加超过呼吸系统的能力,而呼吸系统不能完全适应运动训练。用力呼气流量减少至用力肺活量的25-75% (FEF25-75%),这是小气道功能的标志,可能通过限制运动呼吸急促时可用的最大呼气流量而有助于EFL。本研究调查了训练有素的耐力运动员在有EFL和没有EFL的情况下,FEF25-75%、峰值分钟通气量(V (E))和呼吸模式是否存在差异。方法:40名高强度耐力运动员(男20名,女20名;V * O2max: 59.6±9.2mL∙kg-1∙min-1)完成肺活量测定和最大增量心肺跑步机运动试验。根据呼气末肺容量,通过在最大流量-容量环路内叠加潮汐流量-容量环路来评估EFL。结果:在最大强度运动中,40%的参与者(n = 16:男性7人,女性9人)发展为EFL,性别差异无统计学意义(P < 0.05)。EFL组运动员FEF25-75%(3.45±0.78比4.16±0.98L∙s-1, P=0.020, d = 0.802)显著低于对照组(3.45±0.78比4.16±0.98L∙s-1, P=0.020, d = 0.802),通气需气量比(V (E) /V (Ecap))(0.86±0.14比0.66±0.11,PE)显著高于对照组(P < 0.05)。结论:在一组训练有素的耐力运动员中,最大限度的跑步机运动期间的EFL似乎主要是由产生呼气流量的能力降低引起的,FEF25-75%的降低证明了这一点,而不是通气需求的差异。
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引用次数: 0
Ventilation differences in the menstrual cycle: A systematic review and meta-analysis 月经周期的通气差异:一项系统回顾和荟萃分析
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-06-30 DOI: 10.1016/j.resp.2025.104468
Catherine A. Rattley , Paul Ansdell , Louise Burgess , Malika Felton , Susan Dewhurst , Matthew Armstrong , Rebecca Neal
<div><h3>Background</h3><div>Minute ventilation (V̇E) may vary across the menstrual cycle due to cyclical changes in sex hormones, potentially exerting an exercise intensity dependent effect.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aimed to quantify differences in V̇E, respiratory frequency (RF), and tidal volume (VT) between the follicular and luteal phases at rest, during submaximal exercise (≤90 %V̇O<sub>2max</sub>), and at incremental maximum (100 %V̇O<sub>2max</sub>).</div></div><div><h3>Methods</h3><div>The systematic review adhered to PRISMA guidelines for conducting and reporting systematic reviews. Studies included healthy eumenorrheic females (≥18 years) not using hormonal contraceptives. Studies that reported V̇E in the follicular and luteal phases were included. RF and VT were extracted as secondary outcome measures. Searches were conducted in Cochrane, PubMed, and EBSCO databases in January 2025. Study quality was assessed using the modified Downs and Black checklist for menstrual cycle research. Data were extracted and analysed using maximum likelihood random-effect meta-analyses followed with meta-regressions with intensity and duration as a moderator in submaximal exercise. Publication bias was assessed using Egger’s test. Meta-regressions were also conducted for resting and submaximal datasets using change in progesterone as a moderator.</div></div><div><h3>Results</h3><div>A total of 35 studies inclusive of 743 participants and 64 paired datasets were included. V̇E was lower in the follicular phase than the luteal phase at rest (ES = −0.64, <em>p</em> < 0.001, I<sup>2</sup> = 75.74 %) and during submaximal exercise (ES = −0.89, <em>p</em> < 0.001, I<sup>2</sup> = 76.58 %), with no effect of study quality. Meta-regression revealed that duration and intensity did not influence menstrual cycle effect on V̇E in submaximal exercise. At incremental maximum, a small but significant effect was observed towards higher V̇E in the luteal phase than the follicular phase (ES = −0.33, <em>p</em> = 0.03, I<sup>2</sup> = 61.5 %) however this effect was no longer observed after removal of low-quality studies. All analyses were coupled with significant heterogeneity. Meta-regression demonstrated that change in progesterone significantly predicted V̇E changes during submaximal exercise (<em>p</em> = 0.02), but not at rest (<em>p</em> = 0.07). RF and VT analyses suggested minimal menstrual cycle effect, with only VT reductions at rest contributing to V̇E differences, this was likely related to the low number of studies included.</div></div><div><h3>Conclusions</h3><div>The menstrual cycle significantly influences V̇E, with lower values in the follicular phase at rest and during submaximal exercise. Changes in progesterone partially explain the differences in V̇E between menstrual phases during exercise but not at rest. At maximal intensities, hormonal influence on V̇E is minimal which corroborates the h
背景:由于性激素的周期性变化,每分钟通气量(V (E))可能在月经周期中发生变化,可能产生运动强度依赖效应。目的:本系统综述和荟萃分析旨在量化静息、次极大运动(≤90 %V * O2max)和最大增量运动(100 %V * O2max)时卵泡期和黄体期的V * E、呼吸频率(RF)和潮气量(VT)的差异。方法系统评价遵循PRISMA指南进行和报告系统评价。研究对象为未使用激素避孕药的健康痛经女性(≥18岁)。研究报告了卵泡期和黄体期的V (E)。提取RF和VT作为次要结局指标。检索于2025年1月在Cochrane、PubMed和EBSCO数据库中进行。研究质量采用经修改的Downs和Black月经周期研究检查表进行评估。数据提取和分析采用最大似然随机效应荟萃分析,随后进行荟萃回归,以强度和持续时间作为次最大运动的调节因素。采用Egger’s检验评估发表偏倚。使用孕酮变化作为调节因子,还对静息和次极大数据集进行了meta回归。结果共纳入35项研究,743名受试者,64组配对数据集。静息时卵泡期的V (E)比黄体期低(ES = - 0.64, p <; 0.001,I2 = 75.74 %)和次最大运动时的V (E) (ES = - 0.89, p <; 0.001,I2 = 76.58 %),对研究质量没有影响。meta回归分析显示,持续时间和强度不影响月经周期对亚极限运动时V (E)的影响。在最大增量时,观察到黄体期比卵泡期有较小但显著的影响(ES = - 0.33, p = 0.03,I2 = 61.5 %),但在剔除低质量研究后,不再观察到这种影响。所有分析均伴有显著异质性。meta回归显示,孕酮水平的变化显著预测了亚极限运动时的V (E)变化(p = 0.02),而在静止状态下则不显著(p = 0.07)。RF和VT分析表明,月经周期的影响最小,只有静止时VT降低才会导致V (E)差异,这可能与纳入的研究数量较少有关。结论月经周期明显影响V (E),在卵泡期休息和次极大运动时V (E)较低。黄体酮的变化部分解释了运动时而不是休息时不同月经期的V (E)差异。在最大强度下,激素对肺活量的影响最小,这证实了生理机制在高强度下优于激素介导的通气反应的假设。这些发现提示了运动表现的潜在影响,特别是黄体期耐力活动,因为过度通气的可能性增加。
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引用次数: 0
A comparative analysis of computational models for respiratory frequency 呼吸频率计算模型的比较分析。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-06-21 DOI: 10.1016/j.resp.2025.104458
Anshuman Vikram, Tanmay Pal
Effective mechanical ventilation depends on precise control of multiple parameters, including respiratory frequency. This study explores the influence of respiratory frequency on ventilation through a comparative analysis of four mathematical models. Understanding optimal frequency selection is paramount for ventilator design and control algorithms. Furthermore, the relationship between frequency, minute ventilation, lung resistance, and elastance can aid in managing respiratory diseases. With this approach, the respiratory frequency can be optimized during assisted ventilation, contributing to a better understanding and control of various respiratory therapies. The models were evaluated by varying key physiological parameters such as resistance, elastance, and alveolar ventilation. The effects of parameter variations on predicted respiratory frequencies were illustrated graphically, accompanied by a sensitivity analysis to quantify how changes in parameters influence frequency. To further evaluate model performance, a comparison with published datasets was conducted. This comprehensive assessment ultimately identified a specific model that exhibited the least mean percentage error and closely resembled published data, highlighting its potential for future research and clinical applications.
有效的机械通气依赖于包括呼吸频率在内的多个参数的精确控制。本研究通过四种数学模型的比较分析,探讨呼吸频率对通气的影响。了解最佳频率选择对通风机设计和控制算法至关重要。此外,频率、微小通气、肺阻力和弹性之间的关系有助于控制呼吸系统疾病。通过这种方法,可以优化辅助通气期间的呼吸频率,有助于更好地理解和控制各种呼吸治疗。通过不同的关键生理参数,如阻力、弹性和肺泡通气来评估模型。参数变化对预测呼吸频率的影响以图形方式说明,并附有敏感性分析,以量化参数变化如何影响频率。为了进一步评估模型的性能,与已发表的数据集进行了比较。这项综合评估最终确定了一个特定的模型,该模型显示出最小的平均百分比误差,并且与已发表的数据非常相似,突出了其未来研究和临床应用的潜力。
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引用次数: 0
Effects of threshold inspiratory muscle trainer versus trigger sensitivity adjustment versus conventional therapy on respiratory function in mechanically ventilated patients: a randomized controlled trial. 阈值吸气肌训练器与触发敏感性调节与常规治疗对机械通气患者呼吸功能的影响:一项随机对照试验。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-10-01 Epub Date: 2025-07-03 DOI: 10.1016/j.resp.2025.104469
Heba A.A. Abdeen , Hady Atef , Nesreen G. Elnahas , Omnia A. Khalaf , Youssef M.A. Soliman , Reem I.M. Elkorashy , Samah Mowad , Noemi Moreno-Segura , Juan Jose Carrasco , Elena Marques-Sule

Background

Prolonged mechanical ventilation in chronic obstructive pulmonary disease is associated with severe complications, and then earlier weaning is desirable. Then, strategies such as inspiratory muscle training (IMT) have been studied. This study aimed to compare the effects of IMT via Threshold device versus trigger sensitivity adjustment of the mechanical ventilator versus conventional therapy on respiratory parameters on chronic obstructive pulmonary disease weaning patients.

Methods

Ninety patients (aged 50–70) with acute respiratory failure on mechanical ventilation selected from the Intensive Care Unit were randomly assigned into: IMT via Threshold and conventional physical therapy group; trigger sensitivity adjustment of the mechanical ventilator and conventional physical therapy group; and conventional physical therapy alone group. Negative inspiratory force (NIF), respiratory rate (RR), tidal volume (VT), rapid shallow breathing index (RSBI), pH, and oxygenation parameters (PaO2, PaCO2, and P/F ratio) were measured pre and post-treatment.

Results

Threshold group showed higher improvements in NIF than the trigger sensitivity adjustment group (p = 0.002; ES: 0.91). Threshold group showed better results in all measures than conventional physical therapy group except for pH and PaCO2. Trigger sensitivity adjustment and conventional physical therapy groups showed significant improvements in all measurements (p < 0.005 for NIF (2.30), RR (1.69), VT (0.80); RSBI (2.09), PaO2 (1.20), P/F ratio (1.22) except for VT, pH, and PaCO2 with preference to trigger sensitivity adjustment group. No significant differences were found in the percentage of weaning between groups, but Threshold group showed significantly lower weaning days than conventional physical therapy group (p = 0.004, ES:1.01).

Conclusion

The respiratory training with the IMT device has significantly higher improvements than the other techniques and reduces the weaning duration.
背景:慢性阻塞性肺疾病患者延长机械通气时间与严重并发症相关,因此需要尽早脱机。然后,研究了吸气肌训练(IMT)等策略。本研究旨在比较阈值装置IMT与机械呼吸机触发敏感性调节与常规治疗对慢性阻塞性肺疾病脱机患者呼吸参数的影响。方法选择重症监护病房收治的机械通气急性呼吸衰竭患者90例(50 ~ 70岁),随机分为阈值IMT组和常规物理治疗组;机械呼吸机与常规物理治疗组触发敏感性调整;常规物理治疗单独组。测定治疗前后的负吸气力(NIF)、呼吸频率(RR)、潮气量(VT)、快速浅呼吸指数(RSBI)、pH、氧合参数(PaO2、PaCO2、P/F比)。结果阈值组NIF改善程度高于触发敏感性调整组(p = 0.002;ES: 0.91)。除pH、PaCO2外,阈值组各项指标均优于常规理疗组。触发敏感性调整组和常规物理治疗组在所有测量指标上均有显著改善(p <; 0.005:NIF (2.30), RR (1.69), VT (0.80);除VT、pH、PaCO2外,RSBI(2.09)、PaO2(1.20)、P/F比(1.22)优先触发敏感性调节组。各组断奶率差异无统计学意义,但阈值组断奶天数明显低于常规物理治疗组(p = 0.004,ES:1.01)。结论使用IMT进行呼吸训练比其他方法改善效果明显,缩短了脱机时间。
{"title":"Effects of threshold inspiratory muscle trainer versus trigger sensitivity adjustment versus conventional therapy on respiratory function in mechanically ventilated patients: a randomized controlled trial.","authors":"Heba A.A. Abdeen ,&nbsp;Hady Atef ,&nbsp;Nesreen G. Elnahas ,&nbsp;Omnia A. Khalaf ,&nbsp;Youssef M.A. Soliman ,&nbsp;Reem I.M. Elkorashy ,&nbsp;Samah Mowad ,&nbsp;Noemi Moreno-Segura ,&nbsp;Juan Jose Carrasco ,&nbsp;Elena Marques-Sule","doi":"10.1016/j.resp.2025.104469","DOIUrl":"10.1016/j.resp.2025.104469","url":null,"abstract":"<div><h3>Background</h3><div>Prolonged mechanical ventilation in chronic obstructive pulmonary disease is associated with severe complications, and then earlier weaning is desirable. Then, strategies such as inspiratory muscle training (IMT) have been studied. This study aimed to compare the effects of IMT via Threshold device versus trigger sensitivity adjustment of the mechanical ventilator versus conventional therapy on respiratory parameters on chronic obstructive pulmonary disease weaning patients.</div></div><div><h3>Methods</h3><div>Ninety patients (aged 50–70) with acute respiratory failure on mechanical ventilation selected from the Intensive Care Unit were randomly assigned into: IMT via Threshold and conventional physical therapy group; trigger sensitivity adjustment of the mechanical ventilator and conventional physical therapy group; and conventional physical therapy alone group. Negative inspiratory force (NIF), respiratory rate (RR), tidal volume (VT), rapid shallow breathing index (RSBI), pH, and oxygenation parameters (PaO<sub>2</sub>, PaCO<sub>2,</sub> and P/F ratio) were measured pre and post-treatment.</div></div><div><h3>Results</h3><div>Threshold group showed higher improvements in NIF than the trigger sensitivity adjustment group (p = 0.002; ES: 0.91). Threshold group showed better results in all measures than conventional physical therapy group except for pH and PaCO<sub>2</sub>. Trigger sensitivity adjustment and conventional physical therapy groups showed significant improvements in all measurements (p &lt; 0.005 for NIF (2.30), RR (1.69), VT (0.80); RSBI (2.09), PaO<sub>2</sub> (1.20), P/F ratio (1.22) except for VT, pH, and PaCO<sub>2</sub> with preference to trigger sensitivity adjustment group. No significant differences were found in the percentage of weaning between groups, but Threshold group showed significantly lower weaning days than conventional physical therapy group (p = 0.004, ES:1.01).</div></div><div><h3>Conclusion</h3><div>The respiratory training with the IMT device has significantly higher improvements than the other techniques and reduces the weaning duration.</div></div>","PeriodicalId":20961,"journal":{"name":"Respiratory Physiology & Neurobiology","volume":"337 ","pages":"Article 104469"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multidimensional assessment of breathlessness during exercise: current methods and recommendations 运动中呼吸困难的多维评估:当前的方法和建议。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-08-01 Epub Date: 2025-06-11 DOI: 10.1016/j.resp.2025.104456
Olivia N. Ferguson , Dennis Jensen , Jordan A. Guenette , Hayley Lewthwaite
Dyspnea, or breathlessness, is a complex, multidimensional symptom of breathing discomfort, which significantly impacts quality of life and clinical prognosis. While traditional assessments have primarily focused on breathlessness sensory intensity, this approach does not consider affective and/or qualitative dimensions. Growing evidence highlights the need for multidimensional assessment approaches that provide a more comprehensive understanding of breathlessness, particularly in the context of exercise. Cardiopulmonary exercise testing (CPET) provides a standardized physiological stimulus to assess breathlessness responses in real-time, offering valuable insights into its underlying mechanisms and response to therapeutic intervention. Normative reference equations can help identify abnormally high breathlessness intensity during CPET. This review examines current methodologies for multidimensional breathlessness assessment during exercise, including single-item rating scales, multidimensional tools, descriptor lists, and locus of symptom limitation. We also discuss best practices for linking breathlessness with physiological responses during CPET to enhance mechanistic understanding, inform targeted interventions, and evaluate interventional efficacy. Standardizing assessment approaches and ensuring transparent reporting are critical steps toward improving the clinical and research utility of exertional breathlessness assessments.
呼吸困难是一种复杂的、多方面的呼吸不适症状,严重影响生活质量和临床预后。虽然传统的评估主要集中在呼吸困难的感觉强度,但这种方法没有考虑情感和/或定性方面。越来越多的证据强调需要多维评估方法,以提供对呼吸困难的更全面的了解,特别是在运动的背景下。心肺运动试验(CPET)提供了一种标准化的生理刺激来实时评估呼吸困难反应,为其潜在机制和治疗干预反应提供了有价值的见解。规范的参考方程可以帮助识别CPET期间异常高的呼吸强度。本文综述了目前用于运动过程中多维度呼吸困难评估的方法,包括单项评定量表、多维工具、描述符列表和症状限制位点。我们还讨论了在CPET期间将呼吸困难与生理反应联系起来的最佳实践,以加强对机制的理解,为有针对性的干预提供信息,并评估干预效果。标准化的评估方法和确保透明的报告是迈向提高临床和研究效用的劳力性呼吸困难评估的关键步骤。
{"title":"Multidimensional assessment of breathlessness during exercise: current methods and recommendations","authors":"Olivia N. Ferguson ,&nbsp;Dennis Jensen ,&nbsp;Jordan A. Guenette ,&nbsp;Hayley Lewthwaite","doi":"10.1016/j.resp.2025.104456","DOIUrl":"10.1016/j.resp.2025.104456","url":null,"abstract":"<div><div>Dyspnea, or breathlessness, is a complex, multidimensional symptom of breathing discomfort, which significantly impacts quality of life and clinical prognosis. While traditional assessments have primarily focused on breathlessness sensory intensity, this approach does not consider affective and/or qualitative dimensions. Growing evidence highlights the need for multidimensional assessment approaches that provide a more comprehensive understanding of breathlessness, particularly in the context of exercise. Cardiopulmonary exercise testing (CPET) provides a standardized physiological stimulus to assess breathlessness responses in real-time, offering valuable insights into its underlying mechanisms and response to therapeutic intervention. Normative reference equations can help identify abnormally high breathlessness intensity during CPET. This review examines current methodologies for multidimensional breathlessness assessment during exercise, including single-item rating scales, multidimensional tools, descriptor lists, and locus of symptom limitation. We also discuss best practices for linking breathlessness with physiological responses during CPET to enhance mechanistic understanding, inform targeted interventions, and evaluate interventional efficacy. Standardizing assessment approaches and ensuring transparent reporting are critical steps toward improving the clinical and research utility of exertional breathlessness assessments.</div></div>","PeriodicalId":20961,"journal":{"name":"Respiratory Physiology & Neurobiology","volume":"336 ","pages":"Article 104456"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Swallowing and ventilation patterns in stable COPD patients: An observational study 稳定期COPD患者的吞咽和通气模式:一项观察性研究。
IF 1.9 4区 医学 Q3 PHYSIOLOGY Pub Date : 2025-08-01 Epub Date: 2025-03-28 DOI: 10.1016/j.resp.2025.104419
Virgil Rolland , Armand Bonne , Rimeh Ayari , Grégoire Prum , Eric Verin
Our study aimed to investigate swallowing coordination by analyzing ventilatory patterns during of solids and liquids food intakes. Twenty-one patients with severe to very severe stable COPD (GOLD III and IV) underwent ventilation and swallowing recordings while performing standardized swallowing tasks. The results revealed that the expiratory-expiratory (EE) swallowing pattern was predominant, accounting for 80 % of swallows, with no significant differences between solid and liquid swallows. Non-EE patterns occurred in an average of 20.68 % of swallows per patient. Our results demonstrated an increased inspiratory time (IT) during liquid swallows compared to rest (1.05 ± 0.28 s vs 1.29 ± 0.22 s; p < 0.0125), as well as prolonged expiratory time (ET: 2.09 ± 0.78 s vs 3.42 ± 1.16 s; p < 0.001) and total respiratory cycle time (TT: 3.14 ± 1.03 s vs 4.70 ± 1.21 s; p < 0.01) during both solid and liquid swallows compared to rest. These changes resulted in a decreased IT/TT ratio during swallowing. Our findings confirm that the EE swallowing pattern remains predominant in stable COPD patients, consistent with observations in healthy individuals. Additionally, the study highlights significant alterations in ventilatory patterns during swallowing. These results contribute to a better understanding of the interplay between swallowing and ventilation in COPD and its potential implications for airways protection.
我们的研究旨在通过分析固体和液体食物摄入时的通气模式来研究吞咽协调。21例重度至极重度稳定期COPD (GOLD III和IV)患者在执行标准化吞咽任务时进行通气和吞咽记录。结果显示,以呼气-呼气(EE)吞咽方式为主,占吞咽方式的80%,固体吞咽与液体吞咽无显著差异。每位患者平均有20.68%的燕子出现非ee模式。我们的研究结果表明,与休息时相比,液体吞咽时吸气时间(IT)增加(1.05±0.28s vs. 1.29±0.22s;p < 0.0125),以及呼气时间延长(ET: 2.09±0.78s vs. 3.42±1.16s;p < 0.001)和总呼吸周期时间(TT: 3.14±1.03s∶4.70±1.21s;P < 0.01)。这些变化导致吞咽时IT/TT比值降低。我们的研究结果证实,在稳定型COPD患者中,EE吞咽模式仍然占主导地位,这与健康个体的观察结果一致。此外,该研究还强调了吞咽过程中通气模式的显著改变。这些结果有助于更好地理解COPD患者吞咽和通气之间的相互作用及其对气道保护的潜在影响。
{"title":"Swallowing and ventilation patterns in stable COPD patients: An observational study","authors":"Virgil Rolland ,&nbsp;Armand Bonne ,&nbsp;Rimeh Ayari ,&nbsp;Grégoire Prum ,&nbsp;Eric Verin","doi":"10.1016/j.resp.2025.104419","DOIUrl":"10.1016/j.resp.2025.104419","url":null,"abstract":"<div><div>Our study aimed to investigate swallowing coordination by analyzing ventilatory patterns during of solids and liquids food intakes. Twenty-one patients with severe to very severe stable COPD (GOLD III and IV) underwent ventilation and swallowing recordings while performing standardized swallowing tasks. The results revealed that the expiratory-expiratory (EE) swallowing pattern was predominant, accounting for 80 % of swallows, with no significant differences between solid and liquid swallows. Non-EE patterns occurred in an average of 20.68 % of swallows per patient. Our results demonstrated an increased inspiratory time (IT) during liquid swallows compared to rest (1.05 ± 0.28 s vs 1.29 ± 0.22 s; <em>p</em> &lt; 0.0125), as well as prolonged expiratory time (ET: 2.09 ± 0.78 s vs 3.42 ± 1.16 s; <em>p</em> &lt; 0.001) and total respiratory cycle time (TT: 3.14 ± 1.03 s vs 4.70 ± 1.21 s; <em>p</em> &lt; 0.01) during both solid and liquid swallows compared to rest. These changes resulted in a decreased IT/TT ratio during swallowing. Our findings confirm that the EE swallowing pattern remains predominant in stable COPD patients, consistent with observations in healthy individuals. Additionally, the study highlights significant alterations in ventilatory patterns during swallowing. These results contribute to a better understanding of the interplay between swallowing and ventilation in COPD and its potential implications for airways protection.</div></div>","PeriodicalId":20961,"journal":{"name":"Respiratory Physiology & Neurobiology","volume":"336 ","pages":"Article 104419"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Respiratory Physiology & Neurobiology
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