Effect of breathing re-training on end-tidal carbon-di-oxide in patients with asthma: a systematic review and meta-analysis

Abstract

Objective

The review aims to determine the effect of breathing re-training on End-tidal carbon-di-oxide (ETCO₂) in patients with asthma.

Data sources

A systematic search of articles was performed in PubMed, Cochrane, PEDro, Scopus, and Ovid databases from their inception till May 2022.

Study selections

Studies were included if the patients were clinically diagnosed with mild-moderate asthma. Randomized controlled trials that monitored ETCO₂ as a primary or secondary outcome were included. Studies were examined for potential risk of bias using the Revised Cochrane risk of bias tool by two independent reviewers.

Results

Eight articles were included. The trials used various techniques like Buteyko, Papworth, Biofeedback, and holistic approach. Quantitative analysis was conducted to examine the effects on ETCO₂ at various time points. A significant large effect was seen on ETCO₂ following breathing re-training post-treatment, 3 and 6 months post-intervention.

Conclusion

There is moderate evidence for a significant effect of breathing re-training on ETCO₂ in the short and long term in patients with asthma. However, high-quality randomized controlled trials using standardized measurement of ETCO₂ are required to evaluate the effects of different breathing re-training techniques.

Keywords:

• Chronic respiratory disease
• breathing
• hypocapnia
• biofeedback

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.