Hyperventilation Syndrome Research Articles

Cardio-respiratory studies on glass bangle workers.

Cardio-respiratory functions were recorded in 18 glass bangle workers (Belanias) who worked near the belan furnace continuously for 2 h. The workers were exposed to high ambient temperature (tDB 38.2 degrees C +/- 3.4 degrees C) and thermal radiation (tG 46.2 degrees C +/- 5.1 degrees C) during their work. The physiological responses recorded after the work spell at 1 (R1) 3 (R3) and 5 (R5) minute intervals exhibited incomplete recovery. The oral temperature remained significantly high (0.74 degrees F +/- 0.27 degrees F) even at R5 and never reached pre-work value. Similarly the heart rate values remained very high (26.4 +/- 5.4 beats/min) at R1, (10.7 +/- 3.9 beats/min) at R3 and (4.01 +/- 2.4 beats/min) at R5 periods during recovery, thereby showing that heart rate did not regain the pre-work status. The incomplete recovery in heart rate revealed cardiac stress in the exposed workers. Besides the cardiac stress, the cardiac cost of the work under the prevailing hot conditions in the glass bangle industry was very high, adding further to circulatory strain in these workers. Almost all the exposed workers were found to have hyperventilation syndrome characterized by increased respiratory frequency and tidal volume resulting in ventilatory stress induced by physical and physiological heat.

Respiratory psychophysiological patterning among hyperventilation syndrome patients and healthy controls

Respiratory psychophysiological patterning among hyperventilation syndrome patients and healthy controls

Physiotherapy in management of the hyperventilation syndrome

Physiotherapy in management of the hyperventilation syndrome

Behavioral treatment of angina-like chest pain in patients with hyperventilation syndrome

The hyperventilation syndrome is present in as many as 50% of patients with non-cardiac chest pain. This study evaluated a behavioral treatment of this disorder in three adult females. They had long histories of chest pain and were documented to be free of coronary artery disease. Each subject met the DSM-III-R diagnostic criteria for an anxiety disorder. Following treatment, all subjects showed a marked decrease in the frequency and intensity of chest pain episodes and in the frequency of shortness of breath episodes. Two subjects maintained their progress at one-year follow-up. The results lend support to the efficacy of controlled breathing and relaxation training for the treatment of hyperventilation-related chest pain and to the inclusion of a hyperventilation provocation test in the diagnosis of the syndrome as well as its role in changing cognitions regarding cardiac status. Also discussed is the rationale for treating hyperventilation related chest pain in a medical care setting.

Diagnostic significance of flow separation in the carotid bulb.

Pulsatile blood flow within the normal carotid sinus involves at least two distinct components. That near the flow divider is laminar and antegrade, whereas a boundary layer separation zone in the posterolateral aspect exhibits transient blood flow reversal. It is now possible to document these flow velocity components using pulsed Doppler ultrasound methods. When atherosclerosis develops, it preferentially involves the posterolateral bulb region, obliterating the normal configuration of the sinus with consequent loss of the flow separation zone. It was therefore hypothesized that if flow separation could be detected, it should be predictive of a normal angiogram. To assess this, we evaluated 20 symptomatic patients and two with only bruits found by duplex scanning to have flow separation in either one or both carotid bulbs and who also underwent cerebral angiography. Initial diagnoses were stroke in seven, reversible ischemic neurologic deficit in one, transient ischemic attack in 12, and bruit in two. Flow separation was bilateral in 13 patients (59%). There were 15 patients with symptoms in the territory of a carotid bulb exhibiting flow separation. By angiography, of the 35 bulbs with boundary layer separation, 27 (77%) were normal, with the remainder showing lesions that reduced the diameter of the vessel by 20% or less. Final diagnoses of the 15 patients with symptoms ipsilateral to a carotid sinus exhibiting flow separation were fibromuscular disease in two, lacunar stroke in three, dissection in two, subclavian steal in one, cardiogenic embolus in three, migraine in one, hyperventilation syndrome in one, kink of the mid-internal carotid artery in one, and no diagnosis in one.(ABSTRACT TRUNCATED AT 250 WORDS)

The hyperventilation syndrome in panic disorder, agoraphobia and generalized anxiety disorder

The symptom complex of panic disorder and generalized anxiety disorder suggests an etiological role for hyperventilation. The present study investigates the overlap between DSM-III-R panic disorder, panic disorder with agoraphobia and generalized anxiety disorder with hyperventilation syndrome (HVS). The anxiety disorder diagnoses were based on a structured interview, and HVS determined by the so-called hyperventilation provocation test (a brief period of voluntary hyperventilation with recognition of symptoms). The overlap rates with HVS were: 48% for panic disorder, 83% for panic disorder with agoraphobia and 82% for generalized anxiety disorder. However, a pilot study on transcutaneous monitoring of carbon dioxide tension leads us to question the validity of the voluntary hyperventilation method that we used to determine HVS-status. It is unclear whether hyperventilation plays an important role in panic and general anxiety, as our overlap findings suggest. For patients who recognize the symptoms induced by voluntary hyperventilation, the hyperventilation provocation procedure provides a therapeutic means of exposure to feared bodily sensations.

Functional somatic complaints in adolescents: Relationship to negative life events, self-concept, and family characteristics

While recurrent somatic complaints are commonly encountered in children and adolescents, occult organic disease is rarely found in patients with these complaints. Recent studies have confirmed the clinical impression that a relationship exists between functional somatic complaints and negative life events in adolescents. Our goal was to investigate additional psychosocial characteristics that may be associated with functional complaints. One hundred fifteen adolescents coming for the first time to an adolescent medicine clinic completed standard measures of negative life events, psychophysiologic symptoms, self-esteem, peer social comparison, and family functioning before an independent evaluation by a physician. Patients with functional somatic complaints (chest pain, recurrent abdominal pain, limb pain, and hyperventilation syndrome) reported significantly more negative life events, lower self-esteem, more psychophysiologic symptoms and a lower self-evaluation than did patients coming for physical examination or routine health maintenance. Functional somatic complaints in adolescents may be associated with poor psychosocial adjustment and reaction to negative life events. In addition to ruling out organic disease, physicians dealing with these patients should evaluate other areas, including stressful life events, peer relations, and self-esteem.

Studying the control of breathing in man

The control system of breathing can be considered as a closed-loop system, consisting of two subsystems: the controlling system and the controlled system. Both subsystems are defined by their input-output relationships. In the controlling system the input is the blood gas value; the output is some parameter of ventilation. The controlled system is characterized by an input of ventilation, and an output of blood gas values. In the closed-loop situation the control of breathing can be influenced by outside "disturbances", threatening to disrupt the regulation of the constancy of the internal environment. When studying the control of breathing, and therefore studying the strengths or defects of this homeostatic system, one has to decide whether one intends to investigate the closed-loop or the open-loop situation, and which defect in a subsystem may be the cause of a disrupted homeostasis. What non-feedback stimuli may be active at the moment of the investigation? How can they be kept constant or eliminated? What possible effects from drugs, beverages, nutrients (possibly consumed hours earlier) may still be present? In particular, the output parameters of the controlling system should be carefully chosen to represent that part of the system that one intends to investigate. Disruptions of the control of breathing may have serious consequences for several categories of patients, e.g. those with chronic obstructive pulmonary disease (COPD), asthma, sleep apnoea, sudden infant death syndrome, several neurological syndromes, and the hyperventilation syndrome. Adequate investigation of the control of breathing in these patients is of great importance for their treatment.

The Hyperventilation Syndrome: Research and Clinical Treatment

The Hyperventilation Syndrome: Research and Clinical Treatment

Hypnotic examination of trigger factors in the hyperventilation syndrome.

Abstract The study examines the effects of emotional challenge under hypnosis on patients presenting symptoms of hyperventilation. Hypnosis proved a highly effective method of uncovering triggers for hyperventilation attacks, which were not easily apparent from either personal histories or the subjects' own awareness and recollection of events. Subjects who hyperventilated to hypnotic presentation of a situational stressor, but were negative to forced hyperventilation provocation testing, were found to differ significantly on aspects of the Leary Adjective Check List, when compared to those subjects who were positive to the forced hyperventilation provocation test. The authors conclude that there may be two quite different groups of hyperventilators, which would account for differences of opinion in the literature, and they briefly assess the implications of this proposal.

Hyperventilation syndrome and muscle fatigue

Fatigue is a frequent complaint from patients suffering from the hyperventilation syndrome. Fatigue was quantified in terms of the endurance time that a certain force can be generated in a sustained handgrip contraction, and in terms of the time course of changes in certain parameters of the EMG-power spectrum of the contracting muscles. This was done in a group of 25 normal subjects and a group of 30 patients suffering from the hyperventilation syndrome. No difference in endurance times was found. The EMG-fatiguability in the hyperventilation group developed even slower than in the normal group. In three normals the fatigue parameters were also measured in three conditions of normo-, hypo-, and hyper-capnia. No intraindividual correlations were found between fatigue parameters and CO 2-levels. Neither were such correlations found between individuals in the hyperventilation group and the normal group. It is concluded that the subjective feelings of fatigue in the hyperventilation patients cannot be corroborated by the objective measurements used in this study. Thus their fatigue is not of a peripheral type. The levels of CO 2 do not have an effect on objectively measured ftigue parameters. The hypothesis that lactate accumulation in contracting muscles mediates EMG-fatiguability, cannot explain the present results, and therefore is not supported by results from this study.

Slow recovery of the end-tidal PCO2 after hyperventilation provocation test in hyperventilation syndrome (HVS)

Slow recovery of the end-tidal PCO2 after hyperventilation provocation test in hyperventilation syndrome (HVS)

The Hyperventilation Syndrome: Research and Clinical Treatment

The Hyperventilation Syndrome: Research and Clinical Treatment

The Velocity Step Test

The effect of flunarizine (10 mig/day) was studied in open and double-blind clinical trials. Patients presenting the symptom of dizziness were diagnosed as having the hyperventila-tion syndrome. They showed vestibular hyperreactivity in the velocity step test. This test was performed before and after 4–6 weeks of treatment. The results of treatment were compared with a control or placebo group. In an open trial, 12 of 14 patients reported alleviation of dizziness during treatment and showed a significant decrease in right-left asymmetry of their velocity step responses. In a double-blind trial, no significant difference in effects or side effects was found between the drug and placebo groups.

Review of The Hyperventilation Syndrome: Research and Clinical Treatment.

Review of The Hyperventilation Syndrome: Research and Clinical Treatment.

Do children panic?

Clinical surveys and epidemiological studies suggest that few if any children experience unexpected, uncued (spontaneous) panic attacks. Similarly, few if any children present with panic disorder. Based on emerging behavioral and emotion theory views of panic, several “requirements” seem necessary for an individual to develop panic disorder. First, the individual must experience the abrupt physiological sensations characteristic of panic. In addition, empirical evidence suggests that the individual must have the cognitive capacity to experience attributions of “losing control,” or “going crazy.” Evidence from the literature on childhood hyperventilation syndrome suggests that children may be experiencing panic attacks without the cognitive component. Data on developmental stages in children's conceptions of illness from a Piagetian viewpoint suggests that children may not have the cognitive capacity to develop panic disorder (as opposed to simple phobia). Implications of these ideas for research on childhood anxiety and panic are outlined.

The Hyperventilation Syndrome. By R. Fried. (Pp. 165; illustrated; £19.65.) Johns Hopkins University Press: Baltimore. 1987.

The Hyperventilation Syndrome. By R. Fried. (Pp. 165; illustrated; £19.65.) Johns Hopkins University Press: Baltimore. 1987.

Hyperventilation syndrome or panic disorder--what's in the name?

Hyperventilation syndrome or panic disorder--what's in the name?

Hyperventilation Syndromes in Medicine and Psychiatry

Hyperventilation Syndromes in Medicine and Psychiatry

The role of the nurse counsellor in patients with the hyperventilation syndrome

The role of the nurse counsellor in patients with the hyperventilation syndrome