[Hyperventilation syndrome, definition, diagnostic and therapy]. / Le syndrome d'hyperventilation, définition, diagnostic et thérapeutique.

Hyperventilation syndrome (HVS) is a frequent disorder of which the etiology is unclear. Diagnosis is based on the ruling out of organic disease and, more positively, on results of the Nijmegen questionnaire, reproduction of symptoms during the hyperventilation provocation test (HPVT), and detected hypocapnia. Treatment is based on targeted respiratory physiotherapy consisting in voluntary hypoventilation and instructions to the patient on regular respiratory exercise over an appreciable period of time. Additional research is needed to evaluate the validity of current investigative tools leading to the diagnosis of hyperventilation syndrome and to appraise the efficacy of current respiratory physiotherapy methods.

[Chest physiotherapy techniques - can they reduce hyperinflation]. / Les techniques de médecine physique peuvent-elles pallier la distension?

The authors review the literature concerning the possibilities of modifying the mechanical characteristics of the respiratory system with breathing retraining and other chest physiotherapy intervention. Breathing retraining techniques with prolonged and active expiration induce increased work of breathing and do not help diaphragmatic function. Only pursed lips breathing seems to produce some mechanical advantages. The seated and forward position with fixed arms may reduce dyspnea but this does not appear to be caused by a decrease in operating lung volumes. By contrast, the dorsal decubitus position may reduce hyperinflation, giving some mechanical advantage to the diaphragm but does not reduce dyspnea and is not a position spontaneously adopted by patients. General muscular training may reduce ventilatory demand, and by reducing respiratory frequency lead to a decrease in the end expiratory lung volume; therefore inducing improvement in exercise tolerance.