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1

E, O'Donnell Denis, and Mahler Donald A, eds. Dyspnea: Mechanisms, measurement, and management. 2nd ed. Taylor & Francis, 2005.

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2

A, Mahler Doanld, ed. Dyspnea. Futura Pub. Co., 1990.

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3

A, Mahler Donald, ed. Dyspnea. M. Dekker, 1997.

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4

Keusgen, Ralf Gerhard. Dyspnoe: Untersuchungen mit dem Belastungs-Ganzkörperplethysmographen. [s.n.], 1985.

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5

Handelsman, Harry. Bilateral carotid body resection. National Center for Health Services Research and Health Care Technology Assessment, U.S. Dept. of Health and Human Services, Public Health Service, 1985.

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6

Booth, Sara, and Deborah Dudgeon. Dyspnoea in advanced disease: A guide to clinical management. Oxford University Press, 2006.

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7

Dr, Booth Sara, and Dudgeon Deborah, eds. Dyspnoea in advanced disease: A guide to clinical management. Oxford University Press, 2005.

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8

Brahmabhaṭṭa, Maṇibhāī. Prāṇavahasrotonā rogo śvāsa-damā. Prācyavidyāmandira, Mahārājā Sayājīrāva Viśvavidyālaya, 1995.

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9

Tazim, Virani, and Registered Nurses' Association of Ontario., eds. Nursing care of dyspnea: The 6th vital sign in individuals with chronic obstructive pulmonary disease (COPD). Registered Nurses' Association of Ontario = Association des infirmières et infirmiers autorisés de l'Ontario, 2005.

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10

Tazim, Virani, and Registered Nurses' Association of Ontario. Nursing Best Practice Guidelines Program., eds. Nursing care of dyspnea: The 6th vital sign in individuals with chronic obstructive pulmonary disease (COPD). Registered Nurses' Association of Ontario, Nursing Best Practice Guidelines Program, 2005.

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11

Woo, Kevin Y. The relationships between dyspnea, physical activity, and fatigue in patients with chronic obstructive pulmonary disease. National Library of Canada = Bibliothèque nationale du Canada, 1999.

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12

Tamotsu, Takishima, and Cherniack Neil S, eds. Control of breathing and dyspnea: An international symposium held in Sendai, Japan : 27 & 28 October 1989. Pergamon Press, 1991.

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13

Mukai, Susumu. Ankyloglossia with deviation of the epiglottis and larynx. Annals Pub. Co., 1991.

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14

Pesola, Gene R. Prospective Studies of Proteinuria and Dyspnea as Potential Predictors of All Cause and Chronic-Disease Mortality in a Rural Bangladesh Population. [publisher not identified], 2015.

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15

Weisman, Idelle M., and R. Jorge Zeballos. Clinical exercise testing. W.B. Saunders Co., 1994.

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16

Mahler, Donald A., and Denis E. O'Donnell. Dyspnea: Mechanisms, Measurement, and Management, Third Edition. Taylor & Francis Group, 2014.

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17

Mahler, Donald A. Dyspnea: Mechanisms, Measurement, and Management, Third Edition. Taylor & Francis Group, 2014.

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18

Mahler, Donald A., and Denis E. O'Donnell. Dyspnea: Mechanisms, Measurement, and Management, Third Edition. Taylor & Francis Group, 2014.

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19

Mahler, Donald A., and Denis E. O'Donnell. Dyspnea: Mechanisms, Measurement, and Management, Third Edition. Taylor & Francis Group, 2014.

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20

Mahler, Donald A., and Denis E. O'Donnell. Dyspnea: Mechanisms, Measurement, and Management, Third Edition. Taylor & Francis Group, 2014.

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21

O'Donnell, Denis, and Donald A. Mahler. Dyspnea: Mechanisms, Measurement, and Management. Taylor & Francis Group, 2005.

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22

Managing Breathlessness In Clinical Practice. Springer London Ltd, 2013.

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23

Halfen, Tim, and Kevin Alvarez Losada. Lehrbrief Dyspnoe. Kohlhammer, W., GmbH, 2022.

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24

Dyspnoea in Advanced Disease: A Guide to Clinical Management. Oxford University Press, USA, 2006.

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25

Dyspnea: Mechanisms, Measurement and Management, Second Edition (Lung Biology in Health and Disease). 2nd ed. Informa Healthcare, 2005.

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26

Shaibani, Aziz. Dyspnea. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199898152.003.0009.

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The most common causes of dyspnea are not neuromuscular but rather are cardiac and pulmonary. However, dyspnea is an important and serious manifestation of many neuromuscular disorders, and it may compound an underlying pulmonary or cardiac problem. The diaphragm is a skeletal muscle under the control ofperipheral nerves(phrenic nerves) and may be targeted by inflammatory neuropathies such as Guillain-Barrésyndrome(GBS), chronic inflammatory demyelinating polyneuropathy(CIDP), and brachial plexitis, myopathies such as acid maltase deficiency and muscular dystrophies, and neuromuscular disorders such as myasthenia gravis. Periodic measurement of pulmonary function isrecommended in neuromuscular clinics.
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27

Mahler, Donald A., and Denis O'Donnell, eds. Dyspnea. CRC Press, 2005. http://dx.doi.org/10.1201/b14111.

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28

Hain, Richard D. W., and Satbir Singh Jassal. Dyspnoea. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198745457.003.0011.

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Dyspnoea is defined as the sense that breathing has become unpleasant. It is therefore, by definition, a subjective phenomenon. It also means that many different factors can contribute to dyspnoea. The principles that underlie the management of dyspnoea are the same as those underlying the management of any other symptom, namely, holistic, rational, and balancing burden and benefit. This chapter considers the pathophysiology of dyspnoea, alongside possible interventions and management. There is also a section on decision-making, focusing on the nature of engagement with the family in a subjective condition.
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29

Shaibani, Aziz. Dyspnea. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190661304.003.0009.

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The most common causes of dyspnea are not neuromuscular, but rather cardiac and pulmonary. However, dyspnea is an important and serious manifestation of many neuromuscular disorders, and it may compound an underlying pulmonary or cardiac problem. The diaphragm is a skeletal muscle under the control of a peripheral nerve and may be targeted by inflammatory neuropathies such as Guillain-Barré syndrome (GBS), chronic inflammatory demyelinating polyneuropathy (CIDP), and brachial plexitis or myopathies such as acid maltase deficiency, muscular dystrophy (MD), and neuromuscular disorders such as myasthenia gravis (MG). Periodic measurement of pulmonary function is a recommended measure in neuromuscular clinics.
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30

Broglio, Kathleen. Dyspnea. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190204709.003.0002.

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This chapter provides an overview of the prevalence, pathophysiology, assessment, and clinical management of dyspnea, also known as shortness of breath or air hunger. This chapter describes the current understanding of the pathophysiology of dyspnea, potential causative factors, and evidence-based pharmacologic and nonpharmacologic management. Assessment of dyspnea is outlined using a biopsychosocial approach, emphasizing the understanding that dyspnea is a subjective experience, the severity of which is guided by patient perception. Evidence-based pharmacologic and nonpharmacologic interventions are offered. Guidelines for the use of opioids and benzodiazepines, invasive procedures such as tunneled catheters, and low-tech strategies such as fans to lessen the distress of dyspnea are included.
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31

Mahler, Donald A., and Denis E. O’Donnell, eds. Dyspnea. CRC Press, 2014. http://dx.doi.org/10.1201/b16363.

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32

Hospice and Palliative Nurses Association Staff. Dyspnea. Kendall Hunt Publishing Company, 1999.

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33

George, Ige Abraham, and Glenn Eiger. The Dyspneic Diplomat. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199938568.003.0048.

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These case studies illustrate infections encountered in hospitals among patients with compromised immune systems. As a result of immunocompromise, the patients are vulnerable to common and uncommon infections. These cases are carefully chosen to reflect the most frequently encountered infections in the patient population, with an emphasis on illustrations and lucid presentations to explain state-of-the-art approaches in diagnosis and treatment. Common and uncommon presentations of infections are presented while the rare ones are not emphasized. The cases are written and edited by clinicians and experts in the field. Each case highlights the immune dysfunction that uniquely predisposed the patient to the specific infection, and the cases deal with infections in the cancer patient, infections in the solid organ transplant recipient, infections in the stem cell recipient, infections in patients receiving immunosuppressive drugs, and infections in patients with immunocompromise that is caused by miscellaneous conditions.
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34

Frontline Cardiopulmonary Topics: Dyspnea. Snowdrift Pulmonary Foundation, 2001.

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35

Tarsia, Paolo. Dyspnoea in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0083.

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Dyspnoea may be defined as a subjective experience of discomfort associated with breathing. Breathing discomfort arises as a result of complex interactions between signals relayed from the upper airways, the chest wall, the lungs, and the central nervous system. Integration of this information with higher brain centres provides further processing. The final aspects of the sensation of dyspnoea are influenced by contextual, environmental, behavioural, and cognitive factors. At least three qualitatively distinct sensations have been employed to describe discomfort in breathing—air hunger, increased effort of breathing, and chest tightness. Air hunger has been shown to be associated with stimulation of chemoreceptors. Increased effort of breathing may arise in clinical conditions that impair respiratory muscle performance through abnormal mechanical loads or when respiratory muscles are weakened (neuromuscular diseases). Chest tightness is often experienced by asthmatic patients during episodes of acute bronchoconstriction. Measurement of dyspnoea is essential in order to assess it adequately and monitor response to treatment. Dyspnoea assessment may be carried out thorough a number of different scales, questionnaires, or exercise tests. Strategies in controlling dyspnoea should not focus uniquely on decreasing dyspnoea intensity. Patients may profit from interventions that decrease the unpleasantness associated with breathlessness without necessarily affecting the intensity component of the symptom.
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36

Mahler, Donald A., and Denis E. O'Donnell. Dyspnea: Mechanisms, Measurement, and Management. Taylor & Francis Group, 2014.

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37

Kamal, Arif H., and Jason A. Webb. Effects of Morphine on Dyspnea (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0016.

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This chapter reports on an open, uncontrolled study to assess the effects of subcutaneous morphine on dyspnea in patients with terminal cancer. Twenty patients with dyspnea from restrictive respiratory failure received a subcutaneous dose of morphine relative to their opioid tolerance: 5mg for opioid naïve (5 patients) and 2.5 times regular dose for opioid tolerant (15 patients). Dyspnea and pain scores were measured every 15 minutes for 150 minutes. Dyspnea scores, but not respiratory rate, respiratory effort, nor arterial saturation of oxygen were affected. Ninety-five percent of patients reported improved dyspnea after morphine. This chapter describes the basics of the study and briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case.
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38

Mueller, Christian. Acute dyspnoea in the emergency department. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0009.

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Acute dyspnoea is a very common symptom in the acute cardiac care setting. In contrast to current beliefs, acute dyspnoea, as the leading symptom in the emergency department, is associated with about twice the mortality risk, compared to acute chest pain. Rapid and accurate identification of the cause of dyspnoea is critical to the initiation of specific and effective treatment. In most patients, a rapid and accurate diagnosis in the emergency department can be achieved by a combination of vital signs, including pulse oximetry, detailed patient history, physical examination, blood tests (including natriuretic peptides—BNP, NT-proBNP, or MR-proANP), venous blood gases, and C-reactive protein in all patients, and D-dimers in selected patients, electrocardiograms, and chest X-ray. It is key to remember that the prevalence of acute heart failure in unselected patients with acute dyspnoea is about 50%. Therefore, a high awareness for the presence of acute heart failure is mandatory. Acute heart failure, pneumonia, obstructive pulmonary diseases (chronic obstructive pulmonary disease and asthma), pulmonary embolism, and anxiety disorders represent more than 90% of all cases with acute dyspnoea in the emergency department. In about 10–15%, two acute causes (e.g. acute heart failure and pneumonia) may be present and require combined treatment. Transthoracic echocardiography should be immediately performed in all patients with acute dyspnoea and shock, and in those patients in whom the diagnosis remains uncertain, even after initial work-up.
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39

Mueller, Christian. Acute dyspnoea in the emergency department. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199687039.003.0009_update_001.

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Acute dyspnoea is a very common symptom in the acute cardiac care setting. In contrast to current beliefs, acute dyspnoea, as the leading symptom in the emergency department, is associated with about twice the mortality risk, compared to acute chest pain. Rapid and accurate identification of the cause of dyspnoea is critical to the initiation of specific and effective treatment. In most patients, a rapid and accurate diagnosis in the emergency department can be achieved by a combination of vital signs, including pulse oximetry, detailed patient history, physical examination, blood tests (including natriuretic peptides—BNP, NT-proBNP, or MR-proANP), venous blood gases, and C-reactive protein in all patients, and D-dimers in selected patients, electrocardiograms, chest X-ray, and more recently also lung ultrasound. It is key to remember that the prevalence of acute heart failure in unselected patients with acute dyspnoea is about 50%. Therefore, a high awareness for the presence of acute heart failure is mandatory. Acute heart failure, pneumonia, obstructive pulmonary diseases (chronic obstructive pulmonary disease and asthma), pulmonary embolism, and anxiety disorders represent more than 90% of all cases with acute dyspnoea in the emergency department. In about 10–15%, two acute causes (e.g. acute heart failure and pneumonia) may be present and require combined treatment. Transthoracic echocardiography should be immediately performed in all patients with acute dyspnoea and shock, and in those patients in whom the diagnosis remains uncertain, even after initial work-up.
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40

Crockett, David, and Nicole Shonka. Cough and Dyspnea in a Sarcoma Patient. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199938568.003.0015.

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These case studies illustrate infections encountered in hospitals among patients with compromised immune systems. As a result of immunocompromise, the patients are vulnerable to common and uncommon infections. These cases are carefully chosen to reflect the most frequently encountered infections in the patient population, with an emphasis on illustrations and lucid presentations to explain state-of-the-art approaches in diagnosis and treatment. Common and uncommon presentations of infections are presented while the rare ones are not emphasized. The cases are written and edited by clinicians and experts in the field. Each of these cases highlights the immune dysfunction that uniquely predisposed the patient to the specific infection, and the cases deal with infections in the cancer patient, infections in the solid organ transplant recipient, infections in the stem cell recipient, infections in patients receiving immunosuppressive drugs, and infections in patients with immunocompromise that is caused by miscellaneous conditions.
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41

Lübben, Timm-Oliver. Beratung Bei Dyspnoe Aufgrund Chronisch Obstruktiver Lungenerkrankung Im Kontext Pflegerischen Handelns. GRIN Verlag GmbH, 2013.

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42

Burkin, Julie, Catherine Moffat, Anna Spathis, and Sara Booth. Managing Breathlessness in Clinical Practice. Springer London, Limited, 2013.

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43

Chan, Kin-Sang, Doris M. W. Tse, and Michael M. K. Sham. Dyspnoea and other respiratory symptoms in palliative care. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199656097.003.0082.

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Dyspnoea is prevalent among palliative care patients with increased severity over time. There are two patterns of dyspnoea-breakthrough dyspnoea and constant dyspnoea-and three separate qualities of dyspnoea-air hunger, work or effort, and tightness. The measurement of dyspnoea includes three domains: sensory-perceptual experience, affective distress, and symptom impact. The management of dyspnoea includes specific disease management, non-pharmacological intervention, pharmacological treatment, and palliative non-invasive ventilation. Cough is prevalent and disturbing in patients with cancer and chronic lung diseases, and is often associated with airway hypersecretion and impaired mucociliary clearance. Management includes specific treatments for underlying non-cancer and cancer-related causes, symptomatic treatment by antitussives, mucoactive agents, and airway clearance techniques for expectoration and reduction in mucus production. Anticholinergics may be indicated for death rattles to facilitate a peaceful death. Haemoptysis occurs in 30-60% of lung cancer patients and initial management of haemoptysis includes airway protection and volume resuscitation. Localization of the site and source of bleeding may determine the choice of treatment. If a life-threatening haemoptysis occurs, sedation should be given as soon as possible. Support should be given to the family, and debriefing provided to team members.
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44

Knafelc, Marie E. Effect of ventilatory loads on respiratory mechanics and dyspnea. 1992.

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45

Webb, Jason A., and Arif H. Kamal. Palliative Oxygen Versus Room Air for Refractory Dyspnea (DRAFT). Edited by Nathan A. Gray and Thomas W. LeBlanc. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190658618.003.0017.

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Palliative oxygen therapy is used for treating dyspnea in patients with cancer and advanced cardiopulmonary diseases, however, small trials have suggested that circulating air may be just as effective. This international, multicenter, randomized controlled trial compared oxygen versus room air delivered by a nasal cannula for relief of dyspnea for patients with any life-limiting illness. Patients were adults >18 years of age, with PaO2 > 7.3kPa, on optimized therapies for their illness, and an expected survival of >1 month. The study demonstrated no clinically significant symptomatic benefit of palliative oxygen versus room air delivered via nasal cannula for seven days in patients with life-limiting illnesses and refractory dyspnea.
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46

HOFFER, EDWARD. Rxdx Dyspnea Single User: AN EXERCISE IN CLINICAL PROBLEM-SOLVING. Lippincott Williams & Wilkins, 1996.

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47

HOFFER, EDWARD. Rxdx Dyspnea Inst License: AN EXERCISE IN CLINICAL PROBLEM-SOLVING. Lippincott Williams & Wilkins, 1996.

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48

Stec, Patricia Ashford. COPD clients in the emergency department: Presentation and dyspnea characteristics. 1991.

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49

Waters, Janet. A Woman in Labor with Hypotension and Dyspnea After Epidural Placement. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0022.

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This chapter discusses neurological complications of the administration of epidural and spinal anesthesia in the obstetric population. It begins with a case report on a patient with a total spinal block, which occurs when large doses of local anesthetic intended for the epidural space are inadvertently injected into the subarachnoid space. The chapter reviews key points in recognizing and treating this potentially fatal complication. It discusses other complications, including epidural hematoma, epidural abscess, spinal cord injury, and meningitis, as well as complications from intravascular injection of local anesthetic. Lastly, it discusses how to recognize and treat the most common complication of neuraxial block, post dural puncture headache.
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50

Steele, Bonnie Gail. DIMENSIONS OF DYSPNEA IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A NOCICEPTIVE MODEL. 1991.

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