From the Guidelines
Breathing Pattern in Interstitial Lung Disease (ILD)
The breathing pattern associated with Interstitial Lung Disease (ILD) is characterized by rapid and shallow breathing, with an increased respiratory frequency and a reduced tidal volume (VT) 1.
Key Features
- Restrictive lung mechanics: leading to a reduced ability to increase VT and thus V˙E in response to exercise demands 1
- Increased dead space ventilation: contributing to an increased ventilatory demand 1
- Hypoxemia and pulmonary hypertension: common in ILDs, further complicating breathing patterns 1
- Expiratory flow limitation: described in some patients with ILD, potentially reflecting airway obstruction or disease process involvement 1
Clinical Implications
The abnormal breathing pattern in ILD is primarily due to blunted tidal volume expansion rather than indices of inspiratory effort 1. This pattern contributes to exercise intolerance and dyspnea, key features of ILD 1. Understanding this breathing pattern is crucial for the management and rehabilitation of patients with ILD, as it informs the approach to improving exercise tolerance and quality of life 1.
From the Research
Breathing Patterns in Interstitial Lung Disease (ILD)
- Patients with ILD tend to have a rapid shallow breathing pattern 2
- This breathing pattern is thought to be due to activation of lung reflexes 3
- The rapid shallow breathing pattern is present while awake and does not change significantly during sleep 3
Characteristics of Breathing in ILD
- Expiratory time, inspiratory time, and their sum are shorter in patients with ILD compared to control subjects 3
- The variability of inspiratory volume index, inspiratory time, expiratory time, and inspiratory time/total time is similar to that in control subjects 3
- Oxygen saturation can drop during REM sleep in patients with ILD, especially in those with more severe awake hypoxemia 3
Clinical Implications
- The breathing pattern in ILD can lead to respiratory failure, which is a common complication of the disease 4
- Diagnosis and management of the underlying ILD and respiratory failure pose great challenges 4
- The prognosis and treatment of ILD may vary according to the type of ILD and the cause of the respiratory failure 4