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Molecular Pathophysiology and the Clinical Presentation of COVID-19
Published in Srijan Goswami, Chiranjeeb Dey, COVID-19 and SARS-CoV-2, 2022
Srijan Goswami, Ushmita Gupta Bakshi
Respiration means the action of breathing. It is a biological process involving the production of energy, typically with the intake of oxygen and the release of carbon dioxide from the oxidation of complex organic substances. Respiration is classified into two types (see Figure 3.2). External respiration involves the exchange of oxygen and carbon dioxide between the lungs and blood, while internal respiration involves the exchange of gases between the blood and tissues. Also, respiration occurs in two phases (see Figure 3.2). Inspiration (breathing in), an active process during which air enters the lungs from the atmosphere. Expiration (breathing out), a passive process during which air leaves the lungs (Hall, 2015; Ralston et al., 2018).
Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
The purpose of the lungs is to extract oxygen and at the same expel carbon dioxide with each breath. During CABG surgery, the patient is administered a series of drugs that have the effect of depressing respiratory and cardiovascular function. Because of their effect, these drugs will cause the cessation of spontaneous breathing below life-sustaining levels. Two such indicators of life-sustaining lung function are respiration rate, fR, and tidal volume, Vt (the volume of air inspired in a normal breath). Respiration rate is measured in terms of the number of breaths per minute. The tidal volume is a measure of the amount of air taken into the lungs during the course of a normal breath. In a resting state, the typical human breathes effortlessly at about 12 breaths per minute and a tidal volume commensurate with physiological characteristics associated with the size and weight
Diagnosis of Chronic Fatigue Syndrome
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
The major abnormality related to the pulmonary system is chronic cough. This symptom may sometimes be related to asthma or chronic bronchitis, apparently more common in the CFS population, but also to postnasal drip or a hypersensitivity of the cough receptors. Dyspnea, either at rest or on exertion, is the most frequent complaint, but is probably mediated centrally. Asking the patient to hyperventilate in the office is helpful, although how to treat hyperventilation syndrome is problematic. Fifteen percent of CFS patients hyperventilate, which may cause bronchial constriction. Since the limbic system regulates the automatic control of respiration, hyperventilation could be a limbic dysregulation and may result in an overlap in the diagnosis of CFS and panic disorder. Hyperventilation is seen much more commonly in CFS patients with fibromyalgia.
Vocal cord dysfunction/inducible laryngeal obstruction: novel diagnostics and therapeutics
Published in Expert Review of Respiratory Medicine, 2023
Joo Koh, Debra Phyland, Malcolm Baxter, Paul Leong, Philip G Bardin
The term ‘dysfunctional breathing’ was initially coined to characterize breathing and breathlessness not attributable to medical conditions such as asthma and COPD. There is no consensus about the exact definition of dysfunctional breathing and it may entail hyperventilation as well as more subtle features such as shallow, non-diaphragmatic respiration and abnormal awareness of breathing [55]. Psychological factors such as anxiety, depression, emotional disturbance, and altered cognition may initiate dysfunctional breathing activities or contribute to severity [56]. Studies have indicated that dysfunctional breathing is more often demonstrable in asthmatics (~30%) than in healthy individuals (~10%) [57]. Treatment for dysfunctional breathing improved breathlessness and asthma quality of life without any impact on lung function parameters [58,59]. Importantly, human studies have demonstrated that hyperventilation and an absence of diaphragmatic muscle activity (activities representative of dysfunctional breathing), lead to inspiratory vocal cord narrowing that is reminiscent of VCD/ILO [60–62].
Continuous monitoring of vital signs with the Everion biosensor on the surgical ward: a clinical validation study
Published in Expert Review of Medical Devices, 2021
Marjolein E. Haveman, Rianne van Melzen, Richte C.L. Schuurmann, Mostafa El Moumni, Hermie J. Hermens, Monique Tabak, Jean-Paul P.M. de Vries
Patients who gave informed consent wore the Everion sensor during their stay on the surgical ward. The sensor was worn on the upper arm approximately from 8 am until 10 pm and was charged during the night. Patients, nurses, and researchers were blinded for the sensor measurements, and care was provided as usual. Nurses were instructed to correctly enter their measurement time in the electronic medical record to enable the data pairing needed for assessing validity and reliability. According to the institutional protocol, nurses measured vital signs every 3 hours during the first 24 hours after surgery and subsequently once during an 8-hour nurse shift. Vital signs were collected at the bedside, with the patients sitting or supine. Nurses manually measured HR and SpO2 using the Vital Signs Monitors 53NTO® (Welch Allyn, Amsterdam, the Netherlands). Respiration rate was measured by counting breaths for 15 seconds and multiplying the number by 4 to calculate RR per minute. A temporal scanner (Exergen Corporation, Watertown, MA, USA) was used to monitor temperature.
Respiratory disturbances in fibromyalgia: A systematic review and meta-analysis of case control studies
Published in Expert Review of Respiratory Medicine, 2021
Araceli Ortiz-Rubio, Irene Torres-Sánchez, Irene Cabrera-Martos, Laura López-López, Janet Rodríguez-Torres, María Granados-Santiago, Marie Carmen Valenza
Respiration is a complex function involving the absolute and strict cooperation of muscular, skeletal, and nervous systems [8]. It is rarely completely regular, except in deep non-REM sleep and under anesthesia [11]. Moderate instability reflects a mechanism that is termed dynamic homeostasis. Respiratory function can be influenced by biochemical, biomechanical, and psychological factors, showing an open loop system, vulnerable to adaptations [12–14]. The increased levels of baseline respiratory instability are often associated with pathophysiology either at the level of the sensors of the regulation system (such as hypersensitivity or hyposensitivity of peripheral and central CO2 sensors or proprioceptive afferents) or at the effectors (such as stiffness in the diaphragm or intercostals or inhibited nerve transmission to them) [15]. Additionally, there is a rich network for cortical and subcortical projections to the brain stem (the respiratory center) that can likely influence movement to moment breathing [16].