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Dyspnea: Mechanisms, Measurement, and Management

3rd Edition, January 20, 2014

Complete Document

Detail Summary

Active, Most Current

Additional Comments:
ISBN: 978-1-4822-0869-6
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Product Details:

  • Revision: 3rd Edition, January 20, 2014
  • Published Date: January 20, 2014
  • Status: Active, Most Current
  • Document Language: English
  • Published By: CRC Press (CRC)
  • Page Count: 252
  • ANSI Approved: No
  • DoD Adopted: No

Description / Abstract:


Breathing is an unconscious act. It is only when a perturbation occurs that a person becomes aware of breathing trouble. This complaint, which is known by the medical word dyspnea (dys, disordered; pnea, breathing), was noted in hieroglyphics in Mesopotamia ca. 3300 BC. At present, dyspnea is the most prevalent and challenging symptom for patients with cardiorespiratory diseases. Moreover, patient-reported dyspnea is associated with an increased risk of death in patients with chronic obstructive pulmonary disease (COPD) (Nishimura et al. 2002) and in those with cardiac disease (Abidov et al. 2005).

We are pleased to present the Third Edition of Dyspnea: Mechanisms, Measurement, and Management. Since the Second Edition was published in 2005, there have been major advances in the following areas:

• Knowledge of neurophysiologic

• mechanisms Understanding the different domains of dyspnea measurement

• Recognition and acceptance that dyspnea is a major treatment outcome

• Scientific evidence that many approved therapies reduce dyspnea

• Acceptance of using opioids to relieve disabling and distressful dyspnea

We sincerely and gratefully appreciate the excellent contributions by our friends and colleagues who have enthusiastically written chapters on both new and traditional topics. All of the authors are leaders in different areas within the broad field of dyspnea and provide unique perspectives based on their global diversity.

Why a Third Edition?

In Section I, information on neuromodulation and neuroimaging is presented, which describes our current knowledge of the brain's involvement in the perception of dyspnea. It is possible that future investigations into the function of the central nervous system may provide new treatment approaches for breathing difficulty.

Our understanding of dyspnea as experienced by patients with COPD, asthma, and restrictive disease has been updated, while Chapters 3 and 4 have been added on the effects of aging, sex differences, pregnancy, and obesity on breathlessness.

In Section II, five new chapters have been added that reflect recent developments. For example, the sensory, affective, and impact domains of dyspnea are described in Chapter 7. In Chapter 8, longitudinal changes in dyspnea are reviewed as observed in patients with symptomatic COPD. Chapter 9 considers the regulatory issues and challenges of using dyspnea as an outcome measure in clinical trials. Frequently, psychological problems accompany chronic illness, such that anxiety, depression, and panic may affect breathing difficulty; these interactions are presented in Chapter 10. Finally, Chapter 11 offers practical information on diagnosing the cause of chronic dyspnea in outpatients. This common clinical scenario is relevant to all physicians and health-care providers.

In Section III, Chapters 12 through 16 provide stateof- the-art reviews on treatments that can improve a person's breathing difficulty. As noted in the First and Second Editions of Dyspnea, the majority of information on treatment relates to data obtained in studies of patients with COPD. The primary reasons are the following:

• COPD is the most prevalent respiratory disease throughout the world.

• Patients with symptomatic COPD seek medical care because of their dyspnea.

• Investigators have recruited patients with COPD to participate in clinical studies.

• Pharmaceutical companies have sponsored randomized controlled trials with the major focus on developing new therapies for patients with COPD.

Chapter 16 provides practical information on relieving dyspnea in those patients with advanced disease and are at end of life.

The goal of this Third Edition is to provide current information on the perception of dyspnea as experienced by patients. An added benefit will be if investigators use this information as a framework to identify new directions that expand our understanding and treatment of this troubling symptom.