Articles: dyspnea.
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Post-COVID-19 syndrome (PCS) causes persistent symptoms that impair quality of life, and telerehabilitation (TR) provides an effective remote alternative for addressing these challenges. ⋯ A TR-based exercise program significantly reduced dyspnea and pain intensity while improving functional capacity in PCS patients, making it an effective alternative to unsupervised exercise regimens.
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Curr Opin Crit Care · Feb 2025
ReviewHow to prevent and how to treat dyspnea in critically ill patients undergoing invasive mechanical ventilation.
To summarize current data regarding the prevalence, risk factors, consequences, assessment and treatment of dyspnea in critically ill patients receiving invasive mechanical ventilation. ⋯ As opposed to pain, dyspnea has often been overlooked in terms of detection and management, resulting in its significant underestimation in daily practice. When it is diagnosed, dyspnea can be relieved through straightforward interventions, such as adjusting ventilator settings. Assessing dyspnea in patients undergoing invasive mechanically ventilated may be challenging, especially in noncommunicative patients (RRBS). Implementing a systematic dyspnea assessment in routine, akin to pain, could serve as a first step to reduce RRBS and prevent potential severe psychological consequences. In addition to pharmacological treatments like opioids, a promising approach is to modulate both the sensory (air on the face, trigeminal nerve stimulation) and the affective (relaxing music, hypnosis, directed empathy) components of dyspnea.
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Herein, we report a case of 72-year-old man who had L858R EGFR-mutated lung adenocarcinoma. Chest computed tomography revealed a large lung mass that had completely replaced the right upper lobe. ⋯ Despite the stabilization of his lung cancer, he experienced severe dyspnea and significant weight loss, ultimately leading to a decreased performance status. Chest physicians should recognize that trapped lung can develop as a sequela of dramatic tumor shrinkage in lung cancer.
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Eur. J. Clin. Invest. · Feb 2025
Hemodynamic responses at anaerobic threshold during exercise in preload insufficiency.
Preload insufficiency is an underrecognized cause of exercise intolerance identified during invasive cardiopulmonary exercise testing, and defined hemodynamically by decreased biatrial filling pressures, cardiac output, and oxygen consumption (V̇O2) at peak effort. Patients with preload insufficiency, however, typically present with symptoms of dyspnea on exertion, and/or exercise intolerance at submaximal efforts, particularly when performing activities of daily living. The cardiopulmonary hemodynamics and physiology at submaximal work levels of preload insufficiency have not been previously investigated. We hypothesized that preload insufficiency hemodynamics exist along a continuum, with submaximal exercise values reflecting peak exercise cardiopulmonary hemodynamics. ⋯ These findings underscore the profound impact of preload insufficiency on submaximal exercise capacity, emphasizing the importance of its recognition and management. This insight sets the stage for further investigations into interventions targeting preload insufficiency at submaximal exercise levels to enhance both exercise performance and quality of life.