Maximal inspiratory pressures and dimensions of the diaphragm.

McCool, F. Dennis; Conomos, P; Benditt, Joshua O.; Cohn, David E.; Sherman, Charles B.; Hoppin, F. G.

doi:10.1164/ajrccm.155.4.9105075

Cited by 91 publications

(76 citation statements)

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“…In addition, differences in physiological variables such as thoracoabdominal configuration, differences in the study group and technical issues are suggested to be responsible, at least in part, for the high between-subject variability. Furthermore, the variation in inspiratory pressures has been attributed to the variation in diaphragm thickness [25]. Some published regression equations are even in disagreement, since, for example, height has been shown to be positively predictive [8,14,15], negatively predictive [13] and not predictive [5,9,11,16] for PI,max, and the number of variables included in the final model of the regression equation following stepwise regression varies significantly [5,8,9,11,[13][14][15][16].…”

Section: Resultsmentioning

confidence: 99%

Peak or plateau maximal inspiratory mouth pressure: which is best?

Windisch¹,

Hennings²,

Sorichter³

et al. 2004

Eur Respir J

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There is no clear evidence as to how maximal inspiratory mouth pressure (PI,max) should be measured, although plateau pressures sustained for 1 s and measured at residual volume (RV) are usually recommended.Peak and plateau PI,max were measured at RV and at functional residual capacity (FRC) in 533 healthy subjects (aged 10-90 yrs) in order to comparably test all PI,max measurements for their predictors, reproducibility and normal values.Plateau pressures accounted for 82.0-86.3% of peak pressures. Peak and plateau pressures measured at FRC accounted for 84.3-90.5% of pressures at RV, and were highly correlated. Age was negatively predictive and weight and body mass index positively predictive of PI,max, but regression parameters were low. All PI,max measurements were comparable when calculating regression parameters, between-subject variability and reproducibility.In conclusion, peak and plateau maximal inspiratory mouth pressure are comparably useful for the assessment of inspiratory muscle strength and can be reliably measured at functional residual capacity and at residual volume. Regression equations are of low impact in predicting normal values due to the weak influence of demographic and anthropometric factors and to the high unexplained between-subject-variability. Agerelated 5th percentiles can indicate the lower limit of the normal range. Eur Respir J 2004; 23: 708-713.

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Section: Resultsmentioning

confidence: 99%

Peak or plateau maximal inspiratory mouth pressure: which is best?

Windisch¹,

Hennings²,

Sorichter³

et al. 2004

Eur Respir J

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show abstract

“…Recently, a number of authors have assessed the respiratory muscles in humans, especially the diaphragm, using the ultrasound technique [10][11][12][13]. Both in M-mode and B-mode, ultrasound provides an alternative to other more sophisticated techniques, such as computed tomography, for assessing thickness, configuration and displacement of the diaphragm [16].…”

Section: Background and Validity Of The Methodsmentioning

confidence: 99%

“…This method has been shown reliably to measure changes in diaphragm thickness during contraction [10,11] and has been used to assess the relationship between lung volume and diaphragmatic thickness [10,[12][13][14]. In contrast, to our knowledge, ultrasonographic data on abdominal muscles in humans are scarce both for normal subjects [5,6] and for a number of respiratory diseases in which abdominal muscles contribute importantly to respiration [8].…”

Section: In N V Vi Iv Vo O U Ul Lt Tr Ra As So Ou Un Nd D Amentioning

confidence: 99%

In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects

Misuri

Colagrande²,

Gorini³

et al. 1997

Eur Respir J

166

104

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Ultrasonography has recently been proposed for assessing changes in thickness and motion of the diaphragm during contraction in humans. Data on ultrasound assessment of abdominal muscles in humans are scarce. We therefore investigated the changes in thickness and the relevant mechanical effects of abdominal muscles using this technique during respiratory manoeuvres in normal subjects. We evaluated the thickness of the abdominal muscle layers in six normal male subjects (aged 26-36 yrs) using a 7.5 MHz B-mode ultrasound transducer. Gastric (Pg) and mouth pressures, muscle thickness of external oblique (EO), internal oblique (IO), transversus abdominis (TA) and rectus abdominis (RA) were assessed at functional residual capacity (FRC), residual volume (RV), total lung capacity (TLC), during progressive (PEEs) and maximal expiratory efforts (MEEs) against a closed airway and during homolateral (HTR) and contralateral (CTR) trunk rotation. Abdominal muscle thickness was found to be reproducible (coefficient of variation and two-way analysis of variance). Compared to FRC, the thickness of IO, TA and RA significantly increased at RV and during MEEs, whereas EO remained unchanged; at TLC, the thickness of IO and TA significantly decreased. During PEEs, a significant relationship between increase in Pg and TA thickness was observed in all subjects, the thickness of the other abdominal muscles being inconsistently related to Pg. Finally, a significant increase in the thickness of IO and EO was found during HTR and CTR, respectively. We conclude that during maximal expiratory manoeuvres, transversus abdominis, internal oblique and rectus abdominis thickened similarly. Transversus abdominis seems to be the major contributor in generating abdominal expiratory pressure during progressive expiratory efforts. External oblique seems to be preferentially involved during trunk rotation. These results suggest the possible value of studying the abdominal muscles by ultrasonography in various respiratory disorders.

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“…While MIP measures the strength of inspiratory muscle contraction, MEP measures expiratory muscle strength. (15,16) Previous studies have shown that the variation of MIP among individuals reflects the variation of the structural attributes of the inspiratory muscles, in particular the muscular cross-sectional area of the diaphragm, (17)(18)(19) and that adults with asthma have reductions of up to 30% in maximal respiratory pressures as a result of the effects of hyperinflation. (20) Measurement of maximal respiratory pressures is very well known and also widely used to assess children with chronic lung disease; however, there are questions about the value of respiratory muscle strength in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

Força dos músculos respiratórios em crianças e adolescentes com asma: similar à de indivíduos saudáveis?

2012

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Objective: To compare children/adolescents with mild or moderate asthma and healthy subjects in terms of respiratory muscle strength, correlating it with spirometric variables in the former group. Methods: This was a cross-sectional study involving individuals 6-16 years of age and clinically diagnosed with mild/moderate asthma, together with a group of healthy, age-and gender-matched subjects. We determined spirometric values, as well as MIP and MEP, and we selected three reproducible measurements (variation < 10%). Results: We evaluated 75 patients with asthma and 90 controls. The mean age was 10.0 ± 2.6 years. There were no statistically significant differences between the controls and the asthma group regarding MIP (−89.7 ± 26.7 cmH 2 O vs. −92.2 ± 26.3 cmH 2 O; p = 0.541) or MEP (79.2 ± 22.9 cmH 2 O vs. 86.4 ± 24.0 cmH 2 O; p = 0.256). The groups were subdivided by age (children and adolescents: 6-12 and 13-16 years of age, respectively). Within the asthma group, there was a significant difference between the child and adolescent subgroups in terms of MEP (74.1 ± 24.1 cmH 2 O vs. 92.1 ± 21.9 cmH 2 O; p < 0.001) but not MIP (p = 0.285). Within the control group, there were significant differences between the child and adolescent subgroups in terms of MIP (−79.1 ± 17.7 cmH 2 O vs. −100.9 ± 28.1 cmH 2 O; p < 0.001) and MEP (73.9 ± 18.7 cmH 2 O vs. 90.9 ± 28.1cmH 2 O; p < 0.001). In the asthma group, spirometric variables did not correlate with MIP or MEP. Conclusions: In our sample, asthma was found to have no significant effect on respiratory muscle strength.Keywords: Asthma; Respiratory muscles; Respiratory function tests. ResumoObjetivo: Comparar a força dos músculos respiratórios de crianças e adolescentes com asma leve/moderada com a de indivíduos saudáveis e correlacionar variáveis da espirometria com a força desses músculos nos indivíduos com asma. Métodos: Estudo transversal com indivíduos (6-16 anos de idade) com diagnóstico clínico de asma leve/moderada e voluntários saudáveis pareados por idade e gênero. Foram determinados valores espirométricos, PImáx e PEmáx, sendo selecionadas três medidas reprodutíveis (variação < 10%). Resultados: Foram avaliados 75 pacientes com asma e 90 controles. A média de idade foi de 10,0 ± 2,6 anos. Não houve diferenças estatisticamente significantes entre o grupos controle e asma em relação a PImáx (−89,7 ± 26,7 cmH 2 O vs. −92,2 ± 26,3 cmH 2 O; p = 0,541) e PEmáx (79,2 ± 22,9 cmH 2 O vs. 86,4 ± 24,0 cmH 2 O; p = 0,256). Os dois grupos foram subdivididos em crianças (6-12 anos) e adolescentes (13-16 anos). Nos subgrupos de crianças e adolescentes no grupo asma, houve diferença da PEmáx (74,1 ± 24,1 cmH 2 O vs. 92,1 ± 21,9 cmH 2 O; p < 0,001), mas não da PImáx (p = 0,285). Nos subgrupos de crianças e adolescentes no grupo controle, houve diferenças de PImáx (−79,1 ± 17,7 cmH 2 O vs. −100,9 ± 28,1 cmH 2 O; p < 0,001) e PEmáx (73,9 ± 18,7 cmH 2 O vs. 90,9 ± 28,1 cmH 2 O; p < 0,001). Não houve correlação das variáveis de espirometria com PImáx e PEmáx nos pacientes...

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Maximal inspiratory pressures and dimensions of the diaphragm.

Cited by 91 publications

References 0 publications

Peak or plateau maximal inspiratory mouth pressure: which is best?

Peak or plateau maximal inspiratory mouth pressure: which is best?

In vivo ultrasound assessment of respiratory function of abdominal muscles in normal subjects

Força dos músculos respiratórios em crianças e adolescentes com asma: similar à de indivíduos saudáveis?

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