Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis.

Estenne, Marc; Gevenois, Pierre-Alain; Kinnear, William; Soudon, Philippe; Heilporn, André; Troyer, André De

doi:10.1136/thx.48.7.698

Cited by 107 publications

(76 citation statements)

References 17 publications

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“…In persons with cervical cord injuries, lung compliance is reduced, probably due to airway closure and resulting micro athelectasis, which could contribute to the development of respiratory complications. 5 Mishima et al 6 have shown that lung compliance increases during respiratory training with PEP in persons with chronic obstructive lung disease and normals. If the increase in compliance is related to the attained level of peak inspiratory volume, then the use of a binder would have a negative effect due to the resulting decrease in FRC.…”

Section: Discussionmentioning

confidence: 99%

“…Lung compliance has been found to be reduced in SCL persons 5 and there are reports of increased lung compliance as a result of positive expiratory pressure breathing (PEP) in patients suffering from chronic obstructive lung disease. 6 Presumably, PEP prevents airway closure and atelectasis formation by enhancing expansion of the lungs and by promoting low expiratory flow rates.…”

Section: Introductionmentioning

confidence: 99%

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Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia

Bodin

Olsén

Bake³

et al. 2004

Spinal Cord

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Study design: Cross-sectional, experimental. Objectives: To investigate and compare static lung volumes and breathing patterns in persons with a cervical spinal cord lesion during breathing at rest, ordinary deep breathing, positive expiratory pressure (PEP) and inspiratory resistance-positive expiratory pressure (IR-PEP) with and without an abdominal binder (AB). Setting: The outpatient clinic at the Spinal Unit at Sahlgrenska University Hospital, Go¨teborg, Sweden. Method: The study group consisted of 20 persons with complete cervical cord lesion at C5-C8 level. Breathing patterns and static lung volumes with and without an AB were measured using a body plethysmograph. Results: With an AB, static lung volumes decreased, vital capacity increased, breathing patterns changed only marginally and functional residual capacity remained unchanged during PEP and IR-PEP. Conclusion: Evidence supporting the general use of an AB to prevent respiratory complications by means of respiratory training is questionable. However, the interindividual variation in our results indicates that we cannot rule out that some patients may benefit from the treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia

Bodin

Olsén

Bake³

et al. 2004

Spinal Cord

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“…6,8 Secondly, the limited respiratory-muscles function, such as paralysis of the abdominal and intercostal muscles and the severe decrease in endurance of the innervated respiratory musculature, will contribute to a higher RV and, consequently, a lower iVC. 8 The changes in elastic property of the lung tissue will in¯uence the Pe-max, which may explain the correlation between VC and Pe-max.…”

Section: Inspiratory Vital Capacity and Vo 2 Restmentioning

confidence: 99%

Respiratory muscle strength and endurance in individuals with tetraplegia

et al. 1997

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The purpose of this study was to assess the strength and endurance capacity of the respiratory muscles in individuals with tetraplegia and to compare these properties to those in able-bodied subjects. In addition, the relationship between respiratory muscle properties and respiratory function, ie, ventilation and gas exchange, was examined. Fifteen individuals with tetraplegia (TP) and 15 able-bodied controls (AB) participated in this study. Respiratory muscle strength was assessed by measuring static inspiratory (Pi-max) and expiratory (Pe-max) mouth pressure, whereas inspiratory endurance capacity (Pendu) was determined using an incremental ventilatory threshold loading test. Results were signi®cantly lower in TP compared to AB: Pi-max (5.9 vs 8.4 kPa), Pe-max (5.6 vs 12.3 kPa), Pendu (2.7 vs 6.9 kPa), vital capacity (3.1 vs 5.5 l) and rest oxygen uptake (0.21 vs 0.29 ml/min) and signi®cant correlations were found between the respiratory muscle properties and the respiratory function. Of note is the fact that the ratio Pendu/Pi-max was signi®cantly lower in TP (0.49) compared to AB (0.82). This implies that the capacity to generate pressure during the endurance test was not fully used in TP, probably due to an early onset of muscle fatigue and an altered force-length relationship of the diaphragm muscle. Results of this study demonstrate a limited ability in individuals with tetraplegia to ventilate.

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“…We found that the diaphragm function was preserved in younger DMD patients, whereas the chest wall movement (mainly intercostal muscles) was reduced during maximal inspiration. The reduction in the chest wall motion may also be related to alterations in the elasticity of the lungs associated with diminished lung volumes 32. Note that our patients did not have parenchymal lung disease, thoracic spine kyphoscoliosis, or congestive heart failure,15 which are known to cause reduction in residual volume.…”

Section: Discussionmentioning

confidence: 84%

Respiratory magnetic resonance imaging biomarkers in Duchenne muscular dystrophy

Mankodi

Kovacs

Norato

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo examine the diaphragm and chest wall dynamics with cine breathing magnetic resonance imaging (MRI) in ambulatory boys with Duchenne muscular dystrophy (DMD) without respiratory symptoms and controls.MethodsIn 11 DMD boys and 15 controls, cine MRI of maximal breathing was recorded for 10 sec. The lung segmentations were done by an automated pipeline based on a Holistically‐Nested Network model (HNN method). Lung areas, diaphragm, and chest wall motion were measured throughout the breathing cycle.ResultsThe HNN method reliably identified the contours of the lung and the diaphragm in every frame of each dataset (~180 frames) within seconds. The lung areas at maximal inspiration and expiration were reduced in DMD patients relative to controls (P = 0.02 and <0.01, respectively). The change in the lung area between inspiration and expiration correlated with percent predicted forced vital capacity (FVC) in patients (r s = 0.75, P = 0.03) and was not significantly different between groups. The diaphragm position, length, contractility, and motion were not significantly different between groups. Chest wall motion was reduced in patients compared to controls (P < 0.01).InterpretationCine breathing MRI allows independent and reliable assessment of the diaphragm and chest wall dynamics during the breathing cycle in DMD patients and controls. The MRI data indicate that ambulatory DMD patients breathe at lower lung volumes than controls when their FVC is in the normal range. The diaphragm moves normally, whereas chest wall motion is reduced in these boys with DMD.

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Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis.

Cited by 107 publications

References 17 publications

Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia

Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia

Respiratory muscle strength and endurance in individuals with tetraplegia

Respiratory magnetic resonance imaging biomarkers in Duchenne muscular dystrophy

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