Breathing pattern and central ventilatory drive in mild and moderate generalised myasthenia gravis.

Río, Francisco García; Prados, Concepción; Tejedor, E. Díez; Lobato, Salvador Díaz; Álvarez-Sala, R; Villamor, J.; Pino, Jesús

doi:10.1136/thx.49.7.703

Cited by 28 publications

(15 citation statements)

References 26 publications

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“…These data are consistent with those of KENDRICK et al [22] in thyrotoxic patients. The factors responsible for the abnormalities in time components of the breathing pattern are possibly related to weakness of the respiratory musculature, in the presence of which a rapid breathing rate minimizes the work necessary to achieve a given ventilation [15,[23][24][25]. Basically, afferents arising from the limb and costovertebral joints are expected to be involved in shortening tI and increasing fR [26].…”

Section: Discussionmentioning

confidence: 99%

“…Volume was measured by integration of flow signal. Expiratory time (tE), mean inspiratory flow (VT/tI), duty cycle (tI/ttot), respiratory frequency (fR= 60/ttot) and Time between explorations months 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Graves Graves Graves Graves Graves Graves Graves TNG Graves TNG TNG Graves Graves Graves Graves 3 1 1 2 1 3 3 1 2 2 1 1 1 2 3 2 1a 1b 2 1a 0 1a 1b 1a 2 1b 1b 1a 2 [15,16].…”

Section: Study Methodsmentioning

confidence: 99%

“…Breathing pattern and mouth occlusion pressure were measured as previously described [15]. Breathing pattern was evaluated breathing room air, measuring tidal volume (VT), inspiratory time (tI) and total time of the respiratory cycle (ttot).…”

Section: Study Methodsmentioning

confidence: 99%

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Regulation of breathing in hyperthyroidism: relationship to hormonal and metabolic changes

Pino-García¹,

García‐Río²,

Díez³

et al. 1998

Eur Respir J

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We sought to examine the breathing pattern, inspiratory drive and chemosensitivity of hyperthyroid patients and to explore the interactions between their thyroid hormones, basal metabolism and chemosensitivity. We studied 15 hyperthyroid patients and 15 sex- and age-matched controls. Thyroid hormone levels, arterial blood gas tensions, lung volumes, diffusing capacity for CO, maximal respiratory pressures and oxygen uptake measurements were performed. Breathing pattern and mouth occlusion pressure (P0.1), as well as ventilatory and P0.1 responses to hyperoxic progressive hypercapnia and isocapnic progressive hypoxia, were also evaluated. Compared with the control subjects, the hyperthyroid patients showed significantly lower resting arterial CO2 tension, tidal volume and significantly higher mean inspiratory flow and P0.1. Ventilatory and P0.1 responses to CO2 and hypoxia were also greater in the hyperthyroid patients than in the control group. All these changes returned to normal after treatment. In the patients, significant relationships between tri-iodothyronine and P0.1, P0.1 response to hypoxia, and P0.1 response to hypercapnia were found. In contrast, in hyperthyroidism there was no relationship between oxygen uptake and P0.1 response to hypoxia. We conclude that hyperthyroid patients exhibit a significant relationship between their thyroid hormone levels and their increased inspiratory drive and chemosensitivity.

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Section: Discussionmentioning

confidence: 99%

Section: Study Methodsmentioning

confidence: 99%

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Regulation of breathing in hyperthyroidism: relationship to hormonal and metabolic changes

Pino-García¹,

García‐Río²,

Díez³

et al. 1998

Eur Respir J

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“…At least five repeated determinations were done until three technically satisfactory and reproducible measurements were obtained (variations in PI max <10%). The highest recorded pressures maintained for 1 s were used for analysis [13]. …”

Section: Methodsmentioning

confidence: 99%

Noninvasive Measurement of the Maximum Relaxation Rate of Inspiratory Muscles in Patients with Neuromuscular Disorders

García‐Río

Mediano²,

Pino³

et al. 2006

Respiration

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Background: Slowing of inspiratory muscle relaxation has been used as an index for inspiratory muscle fatigue. However, maximum relaxation rate measured from oesophageal pressure traces after maximum sniff (P_oes MRR) has limited clinical usefulness because it requires an oesophageal balloon catheter system. Objectives: It was the aim of this study to establish whether, in neuromuscular patients, maximum relaxation rate assessed from sniff nasal pressure (P_nasal MRR) reflects oesophageal MRR and the tension-time index of the diaphragm (TT_di). Methods: Twenty patients with neuromuscular disease and 10 healthy subjects were studied. P_oes and transdiaphragmatic pressure were measured while P_nasal was recorded with a balloon advanced through the nose into the nasopharynx. Maximum P_oes, transdiaphragmatic pressure and P_nasal were simultaneously measured while the patients performed maximal sniffs. The MRR (% pressure fall/10 ms) for each sniff, the TT_di and the tension-time index of respiratory muscles were determined. Results: Neuromuscular patients showed higher TT_di, lower P_oes MRR and lower P_nasal MRR than the control group. In patients with neuromuscular disease, the correlation coefficient of P_nasal MRR and P_oes MRR was 0.985 (p < 0.001). Regression analysis showed that P_oes MRR = –1.101 + 1.113·P_nasal MRR (r² = 0.929, standard error of the estimate = 0.208). Indeed, P_nasal MRR was negatively correlated with TT_di (r = –0.914, p < 0.001) and the tension-time index of respiratory muscles (r = –0.732, p < 0.001). In the neuromuscular group, the mean difference between P_nasal MRR and P_oes MRR was 0.286 ± 0.217%/10 ms. Conclusions: P_nasal MRR obtained from a maximal sniff accurately reflects P_oes MRR and TT_di in patients with neuromuscular disorders.

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“…We measured mouth occlusion pressure (P0.1) and tension-time index of inspiratory muscles (TTmu), as previously described. 20,21 An arterial blood gas sample was obtained while patients breathed room air, for the measurement of blood gases.…”

Section: Pulmonary Functionmentioning

confidence: 99%

Relationship between the Upper Airway and Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women

et al. 2007

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Prevalence of OSAS in morbidly obese women is very high. Our results show the significant correlation between BMI and AHI in morbidly obese women. Uvula diameter and retropharynx soft tissue are the upper airway parameters with higher relationship with pulmonary function. A reduction in the cross-sectional area of the airway at the level of the oropharynx could be related to the severity of OSAS in morbidly obese women.

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Breathing pattern and central ventilatory drive in mild and moderate generalised myasthenia gravis.

Abstract: Mild myasthenia gravis causes increased neuromuscular drive with a normal breathing pattern. Moderate myasthenia gravis is characterised by a more rapid shallow breathing pattern.

Cited by 28 publications

References 26 publications

Regulation of breathing in hyperthyroidism: relationship to hormonal and metabolic changes

Regulation of breathing in hyperthyroidism: relationship to hormonal and metabolic changes

Noninvasive Measurement of the Maximum Relaxation Rate of Inspiratory Muscles in Patients with Neuromuscular Disorders

Relationship between the Upper Airway and Obstructive Sleep Apnea-Hypopnea Syndrome in Morbidly Obese Women

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