For more than 3 decades our lab worked to understand the basic neural mechanisms underlying the symptom of dyspnea (shortness of breath, breathlessness). We redefined understanding of afferent pathways, were the first to identify brain regions activated by dyspnea, and more clearly defined the several separate sensations underlying dyspnea.
We then extended our investigations into applied studies relevant to clinical work: We studied pharmacologic interventions to relieve dyspnea (opiates, aerosol chloride channel blockers). We developed a more sophisticated instrument to assess dyspnea in the lab and the clinic, we measured the prevalence and incidence of dyspnea in hospitalized patients and determined its relationship to adverse outcomes.
Our major accomplishments are listed below. The Bibliography Page shows all of our relevant publications, with links to abstracts with graphics and, when available, pdf files of articles.
- We have developed a useful laboratory model of air hunger (uncomfortable urge to breathe, starved for air, one of several sensations categorized as dyspnea). We have defined the static and dynamic stimulus-response characteristics of the air hunger response. (Banzett et al 1996, Banzett 1996) We have shown this laboratory model to be useful in understanding clinical treatments. (Banzett et al 2011)
- We were the first to show that air hunger is unchanged by complete paralysis of respiratory muscles, disproving the widely held view that all dyspnea arose from respiratory muscles. (Banzett et al 1989, Banzett et al 1990)
- It has been known for a century that air hunger is relieved by breathing, even when changes in blood gasses are prevented. We were the first to show this relief comes from pulmonary mechanoreceptors. (Manning et al 1992) and that this relief is the same whether the subject breathes or is mechanically ventilated. (Shea et al 1996, Bloch-Salisbury et al 1998)
- We were the first to show that air hunger adapts to prolonged changes in PCO2 over the course of 2-3 days. (Bloch-Salisbury et al 1996)
- We, together with our sister lab in London, published the first report showing which areas of the cerebral cortex are engaged in the perception of dyspnea (air hunger). (Banzett et al 2000, Evans et al 2002)
- We were the first to show that pulmonary stretch receptor information lung volume is perceived, and that subjects can even detect when a single lung lobe is inflated (via bronchoscope), and can detect on which side the inflation occurs. ( Banzett et al 1987, Banzett et al 1997)
- We obtained the most persuasive evidence to date that the sensation of tightness in asthma arises from pulmonary receptors. (Binks et al 2001).
- Based on our own laboratory experience, reports in the literature, and the more advanced science of pain perception, we developed a theoretical framework positing that dyspnea comprises several uncomfortable sensations. We further posited that each sensation had a sensory quality and and affective component (Lansing et al 2009). This theoretical model is reflected in the very widely cited definition of dyspnea proffered in the American Thoracic Society’s Official Statement on Dyspnea.
- Based on this theoretical framework, and ‘plagiarism’ of various pain measurement instruments, we developed a unified measurement instrument to assess the multiple dimensions of dyspnea, the MULTIDIMENSIONAL DYSPNEA PROFILE (MDP). (Banzett et al 2008, Meek et al 2012, Parshall et al 2012, Banzett et al 2015, Banzett&Moosavi 2017, Stevens et al 2019).
- Using laboratory paradigms to evoke dyspnea, we tested the use of opiates and of aerosolized furosemide to relieve air hunger. (Moosavi et al 2007, Banzett et al 2011, Soffler et al 2017, O’Donnell 2017, Morelot-Panzini et al 2018, Banzett et al 2018, Hallowell 2020)
- The last major effort of the Dyspnea Lab was to take what we had learned to the clinical setting. Working with the Department of Nursing at our hospital, we instituted universal documentation of dyspnea in all med-surg units. We have reported on the prevalence of dyspnea on admission and it’s association with adverse outcomes. (Baker et al 2013, Stevens et al 2016, Stevens et al 2018, Stevens et al 2021) We also surveyed of nurses regarding the value of dyspnea assessment and its impact on workload. (Baker 2017, Baker 2020, Banzett et al 2020)