Respirační symptomy
| Title in English | Respiratory symptoms |
|---|---|
| Authors | |
| Year of publication | 2020 |
| Type | Chapter of a book |
| MU Faculty or unit | |
| Citation | |
| Description | Dyspnea is a subjective experience of breathing discomfort. It represents one of the most frequent clinical symptoms of advanced phases of many diseases including the neurological ones. In neurological patients, dyspnea usually results from hypoventilation. Hypoventilation is the state in which a reduced amount of air enters the alveoli in the lungs, resulting in decreased levels of oxygen and increased levels of carbon dioxide in the blood. Clinically it usually presents with shallow, weak breathing. Both the dyspnea and hypoventilation may occur in serious strokes, brainstem or rostral spinal cord lesions, motor neuron diseases, severe polyneuropathies or myopathies or in myastenia gravis. In clinical practice, the initial symptom of respiratory failure is usually dyspnea on exertion and/or orthopnea. Orthopnea is the dyspnea that occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair. Later on, the dyspnea at rest develops. From the therapeutical point of view, respiratory muscle training in the presymptomatic phase of respiratory manifestation of chronic progressive neurological diseases may help to delay the onset of such symptoms and prolong survival. The already developed respiratory failure can be managed by the invasive or noninvasive artificial ventilation. Alternativelly, symptomatic therapy focused on the decrease of dyspnea and the improvement of the quality-of-life can be provided. An inffective cough represents another frequent complication related to the reduced respiratory muscle strength. These patients suffer from frequent repiratory infections. Subjectively, they perceive decreased effectiveness of the cough and nose-blowing. The most efficient way of management these symptoms is the mechanically assisted cough, mainly the mechanical insufflation-exsufflation using the cough-assist machine. Expectorants and mucolytics may also partially help to improve the cough effectiveness. |