Page 27 - Škrgat, Sabina, ed. 2023. Severe Asthma Forum - Monitoring and Treatable Traits in Severe Asthma. Koper: University of Primorska Press. Severe Asthma Forum, 2
P. 27
results in high operating lung volumes 5. Thoraco-abdominal asynchrony is seen 27
and reduced inspiratory capacity, as in when there is delay between rib cage
HVS. Also, it can frequently manifest and abdominal contraction resulting in
in organic disease, but in the absence of ineffective breathing mechanics.2
disease it may be considered dysfunc-
tional and results in dyspnoea. The most recognized model of DB is HVS,
4. Forced abdominal expiration: these characterized by acute or chronic hyperventi-
patients utilize inappropriate and ex- lation (increased minute ventilation) at rest or
cessive abdominal muscle contraction during exercise/stress. HVS may be part of so-
to aid expiration. This type of DB re- matic/physiological conditions, still it common-
sults in very low lung volumes, and ly develops secondary to psychological/behav-
therefore a reduced functional residu- ioural factors (particularly anxiety, depression,
al capacity. perfectionism, and feelings of inferiority).22–24
dysfunctional breathing – view of pulmonologist
Figure 2. Differential diagnosis between DB and difficult-to-treat asthma and the detrimental effect of DB
on asthma and asthma-related outcomes.30,31
Modified from:
Denton E, Bondarenko J, Tay T, et al. Factors Associated with Dysfunctional Breathing in Patients with DifficulttoTreat Asthma.
J Allergy Clin Immunol Pract. 2019;7(5):1471-1476.
Connett GJ, Thomas M. Dysfunctional Breathing in Children and Adults With Asthma. Front Pediatr. 2018;6:406.
and reduced inspiratory capacity, as in when there is delay between rib cage
HVS. Also, it can frequently manifest and abdominal contraction resulting in
in organic disease, but in the absence of ineffective breathing mechanics.2
disease it may be considered dysfunc-
tional and results in dyspnoea. The most recognized model of DB is HVS,
4. Forced abdominal expiration: these characterized by acute or chronic hyperventi-
patients utilize inappropriate and ex- lation (increased minute ventilation) at rest or
cessive abdominal muscle contraction during exercise/stress. HVS may be part of so-
to aid expiration. This type of DB re- matic/physiological conditions, still it common-
sults in very low lung volumes, and ly develops secondary to psychological/behav-
therefore a reduced functional residu- ioural factors (particularly anxiety, depression,
al capacity. perfectionism, and feelings of inferiority).22–24
dysfunctional breathing – view of pulmonologist
Figure 2. Differential diagnosis between DB and difficult-to-treat asthma and the detrimental effect of DB
on asthma and asthma-related outcomes.30,31
Modified from:
Denton E, Bondarenko J, Tay T, et al. Factors Associated with Dysfunctional Breathing in Patients with DifficulttoTreat Asthma.
J Allergy Clin Immunol Pract. 2019;7(5):1471-1476.
Connett GJ, Thomas M. Dysfunctional Breathing in Children and Adults With Asthma. Front Pediatr. 2018;6:406.
