Page 25 - Škrgat, Sabina, ed. 2023. Severe Asthma Forum - Monitoring and Treatable Traits in Severe Asthma. Koper: University of Primorska Press. Severe Asthma Forum, 2
P. 25
rete the excess bicarbonate ion. Hydrogen tex) and involuntary (neural, emotional, en- 25
ion deficiency suppresses hydrochloric acid docrine, and metabolic) control mechanisms.
formation by the stomach as well. Further on, Numbers of hormones participate in ventila-
in the state of alkalosis, smooth muscles of the tory regulation. For example, hyperventila-
digestive tract also constrict, while haemo- tion with resultant hypocapnia may be pres-
globin slowly delivers smaller amount of oxy- ent during the luteal phase of the menstrual
gen (Bohr effect). Hypocalcaemia, secondary cycle as well as in pregnancy.14 However, res-
to calciuria induced by alkalemia, results in piratory complaints appear to have a strong-
poor muscle and nerve function, e.g. hyper- er relationship to breathing pattern.15 Thus,
excitability of skeletal and visceral muscles. pathophysiological mechanisms underlying
As in the vicious circle, all potential resultant DB require further research on the levels of
symptoms (Table 1) exaggerate previously ex- neural ventilatory control and skeletal muscle
isting anxiety, which in its turn, aggravate dis- metabolic function, which would include pro-
ordered pattern of breathing. The regulation cesses in the normocapnic settings as well.16
of breathing involves both voluntary (cor-
dysfunctional breathing – view of pulmonologist
Figure 1.Pathophysiologic process in hyperventilation
Epidemiology Presentation
The prevalence of DB in general population The key respiratory symptom in dysfunction-
is estimated to be approximately 8%.8 As the al breathing is breathlessness (“air hunger”).
disordered is ill-defined without standardized Non-respiratory associated symptoms may
diagnostic tools, it is hard to estimate its true be attributable to hyperventilation (increased
prevalence. Dysfunctional breathing may af- minute ventilation) and respiratory alkalosis
fect individuals across all age groups and is such as paraesthesia (i.e. tingling), numbness,
more often found in asthmatics who are fe- dizziness, palpitations and, rarely, tetany.
male, with poor asthma control, frequent ex- Also, frequently reported are chest tightness,
acerbations and comorbid anxiety states.17–19 chest pain, deep sighing, exercise-induced
dyspnoea and frequent yawning. However,
ion deficiency suppresses hydrochloric acid docrine, and metabolic) control mechanisms.
formation by the stomach as well. Further on, Numbers of hormones participate in ventila-
in the state of alkalosis, smooth muscles of the tory regulation. For example, hyperventila-
digestive tract also constrict, while haemo- tion with resultant hypocapnia may be pres-
globin slowly delivers smaller amount of oxy- ent during the luteal phase of the menstrual
gen (Bohr effect). Hypocalcaemia, secondary cycle as well as in pregnancy.14 However, res-
to calciuria induced by alkalemia, results in piratory complaints appear to have a strong-
poor muscle and nerve function, e.g. hyper- er relationship to breathing pattern.15 Thus,
excitability of skeletal and visceral muscles. pathophysiological mechanisms underlying
As in the vicious circle, all potential resultant DB require further research on the levels of
symptoms (Table 1) exaggerate previously ex- neural ventilatory control and skeletal muscle
isting anxiety, which in its turn, aggravate dis- metabolic function, which would include pro-
ordered pattern of breathing. The regulation cesses in the normocapnic settings as well.16
of breathing involves both voluntary (cor-
dysfunctional breathing – view of pulmonologist
Figure 1.Pathophysiologic process in hyperventilation
Epidemiology Presentation
The prevalence of DB in general population The key respiratory symptom in dysfunction-
is estimated to be approximately 8%.8 As the al breathing is breathlessness (“air hunger”).
disordered is ill-defined without standardized Non-respiratory associated symptoms may
diagnostic tools, it is hard to estimate its true be attributable to hyperventilation (increased
prevalence. Dysfunctional breathing may af- minute ventilation) and respiratory alkalosis
fect individuals across all age groups and is such as paraesthesia (i.e. tingling), numbness,
more often found in asthmatics who are fe- dizziness, palpitations and, rarely, tetany.
male, with poor asthma control, frequent ex- Also, frequently reported are chest tightness,
acerbations and comorbid anxiety states.17–19 chest pain, deep sighing, exercise-induced
dyspnoea and frequent yawning. However,
