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A physiological model of patient-reported breathlessness during daily activities in COPD

King's College London School of Medicine, King's College Hospital, London, UK

CORRESPONDENCE: C. J. Jolley, Dept of Asthma, Allergy & Respiratory Science, King's College London School of Medicine, King's College Hospital, Bessemer Road, London SE5 9PJ, UK. E-mail: caroline.jolley{at}kcl.ac.uk

Received: December 17, 2008
Accepted March 2, 2009

ABSTRACT

Breathlessness during daily activities has a significant impact on quality of life in chronic obstructive pulmonary disease. Herein, we present a physiological model of patient-reported breathlessness based on the relationship between ventilatory load, respiratory muscle capacity, neural respiratory drive and neuromechanical dissociation during daily activities. This model should facilitate an understanding of the mechanisms driving increased intensity of breathlessness during daily activities and the relief of breathlessness following medical or surgical interventions.

The model should also provide a structure on which to base the development of patient-reported outcome instruments to measure the severity of breathlessness during daily activities in chronic obstructive pulmonary disease.

KEYWORDS: Activities, chronic obstructive pulmonary disease, daily living, dyspnoea, pathophysiology, respiratory mechanics