Neurophysiological mechanisms of dyspnea: From perception to symptoms

Abstract

Dyspnea is one of the major symptoms of acute and chronic respiratory diseases. In the intensive care unit, up to half of mechanically ventilated patients suffer from dyspnea. In these patients, the detection and treatment of dyspnea should be a priority, such as for pain.

Recent pathophysiological key findings have individualized several and various forms of dyspnea, each of them involving given receptors, pathways, and cerebral integration areas. Dyspnea is a multidimensional feeling including emotional and sensorial components. Dyspnea results from an imbalance between the central respiratory command and the ability of the respiratory system to match this demand. Various scores and scales now allow an easy detection, evaluation and characterization of dyspnea in its different components. However, the treatment of dyspnea is still challenging. Few pharmacologically active treatments are available and they all bear potentially deleterious adverse effects. Non-pharmacological treatments are promising techniques but are still under research.