Dyspnoea in children. Does development alter the perception of breathlessness?

Respiratory Physiology & Neurobiology
Cyril Schweitzer, François Marchal

Abstract

Dyspnoea, the perception of an unpleasant and/or uncomfortable sensation of breathlessness, offers several physiological, anatomical and teleological analogies with pain. Pain perception has been shown to exist in the newborn, suggesting that dyspnoea may also occur from birth onwards. The perception of breathlessness will be subservient to developmental changes in the behaviour of sensors and lung and muscular receptors implicated in dyspnoea, some of which are known to be active at time of birth. For example, perinatal resetting of the arterial chemoreceptor could lead to transient depression of the dyspnoeic response to hypoxia. However, though early evoked ventilatory responses and peripheral receptor maturation do exist, dyspnoea will only occur if the corresponding central neural circuitry undergoes parallel maturation. Our knowledge of dyspnoea in later childhood is based on a small number of clinical or psychophysical studies, predominantly dealing with asthma and exercise. There is a thus a clear need for systematic assessment of the existence and severity of dyspnoea sensing in younger children that takes into account its role as an alarm mechanism for triggering adaptive and/or protective responses.

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Citations

May 6, 2014·Respiratory Physiology & Neurobiology·Paolo T PianosiPatrick J McGrath
Dec 28, 2012·Pediatric Research·Isabelle HamonFrançois Marchal
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Jun 24, 2016·Current Allergy and Asthma Reports·Lindsay Still, William K Dolen
Jan 10, 2018·Journal of Palliative Medicine·Lucas PieperJulia Wager
Jul 5, 2018·Frontiers in Pediatrics·Amelia LicariGian L Marseglia
Oct 20, 2018·Pediatric Exercise Science·Paolo T Pianosi
Sep 28, 2020·Paediatric Respiratory Reviews·T Goddard, S Sonnappa

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