dc.contributor.author | Banzett, Robert B | |
dc.contributor.author | Adams, Lewis | |
dc.contributor.author | O'Donnell, Carl R | |
dc.contributor.author | Gilman, Sean A | |
dc.contributor.author | Lansing, Robert W | |
dc.contributor.author | Schwartzstein, Richard M | |
dc.date.accessioned | 2017-05-03T13:12:09Z | |
dc.date.available | 2017-05-03T13:12:09Z | |
dc.date.issued | 2011 | |
dc.date.modified | 2012-03-09T05:28:32Z | |
dc.identifier.issn | 1073-449X | |
dc.identifier.doi | 10.1164/rccm.201101-0005OC | |
dc.identifier.uri | http://hdl.handle.net/10072/43492 | |
dc.description.abstract | Rationale: Opioids are commonly used to relieve dyspnea, but clinical data are mixed and practice varies widely. Objectives: Evaluate the effect of morphine on dyspnea and ventilatory drive under well-controlled laboratory conditions. Methods: Six healthy volunteers received morphine (0.07 mg/kg) and placebo intravenously on separate days (randomized, blinded). We measured two responses to a CO2 stimulus: (1) perceptual response (breathing discomfort; described by subjects as "air hunger") induced by increasing partial pressure of end-tidal carbon dioxide (PetCO2) during restricted ventilation, measured with a visual analog scale (range, "neutral" to "intolerable"); and (2) ventilatory response, measured in separate trials during unrestricted breathing. Measurements and Main Results: We determined the PetCO2 that produced a 60% breathing discomfort rating in each subject before morphine (median, 8.5 mm Hg above resting PetCO2). At the same PetCO2 after morphine administration, median breathing discomfort was reduced by 65% of its pretreatment value; P < 0.001. Ventilation fell 28% at the same PetCO2; P < 0.01. The effect of morphine on breathing discomfort was not significantly correlated with the effect on ventilatory response. Placebo had no effect. Conclusions: (1) A moderate morphine dose produced substantial relief of laboratory dyspnea, with a smaller reduction of ventilation. (2) In contrast to an earlier laboratory model of breathing effort, this laboratory model of air hunger established a highly significant treatment effect consistent in magnitude with clinical studies of opioids. Laboratory studies require fewer subjects and enable physiological measurements that are difficult to make in a clinical setting. Within-subject comparison of the response to carefully controlled laboratory stimuli can be an efficient means to optimize treatments before clinical trials. | |
dc.description.peerreviewed | Yes | |
dc.description.publicationstatus | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | American Thoracic Society | |
dc.publisher.place | United States | |
dc.relation.ispartofstudentpublication | N | |
dc.relation.ispartofpagefrom | 920 | |
dc.relation.ispartofpageto | 927 | |
dc.relation.ispartofissue | 8 | |
dc.relation.ispartofjournal | American Journal of Respiratory and Critical Care Medicine | |
dc.relation.ispartofvolume | 184 | |
dc.rights.retention | Y | |
dc.subject.fieldofresearch | Biomedical and clinical sciences | |
dc.subject.fieldofresearch | Respiratory diseases | |
dc.subject.fieldofresearchcode | 32 | |
dc.subject.fieldofresearchcode | 320103 | |
dc.title | Using Laboratory Models to Test Treatment: Morphine Reduces Dyspnea and Hypercapnic Ventilatory Response | |
dc.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
gro.rights.copyright | Self-archiving of the author-manuscript version is not yet supported by this journal. Please refer to the journal link for access to the definitive, published version or contact the authors for more information. | |
gro.date.issued | 2011 | |
gro.hasfulltext | No Full Text | |
gro.griffith.author | Adams, Lewis | |