Mechanism of CO2 Retention in Patients With Neuromuscular Disease

Misuri, Gianni; Lanini, Barbara; Gigliotti, Francesco; Iandelli, Iacopo; Pizzi, A.; Bertolini, Maria Grazia; Scano, Giorgio

doi:10.1378/chest.117.2.447

Cited by 93 publications

(51 citation statements)

References 28 publications

(52 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1B, C and D To investigate whether the CVrr is useful for estimating hypercapnia in DMD patients, we classified the patients according to the CVrr and hypercapnia (Table 3). Here, we defined "hypercapnia" as PaCO2 greater than 45 mmHg (1,9), and "severe hypercapnia" as PaCO2 greater than 50 mmHg. We usually use the latter value as a critical respiratory failure, and if a patient shows this value, we should consider further respiratory support (1,10).…”

Section: Methodsmentioning

confidence: 99%

Heart Rate Variability and Hypercapnia in Duchenne Muscular Dystrophy

Mochizuki

Okahashi²,

Ugawa

et al. 2008

Intern. Med.

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Heart Rate Variability and Hypercapnia in Duchenne Muscular Dystrophy

Mochizuki

Okahashi²,

Ugawa

et al. 2008

Intern. Med.

View full text Add to dashboard Cite

show abstract

“…4 In patients with NMDs, the reduction of inspiratory and/or expiratory muscle strength is thus related to ineffective alveolar ventilation and difficult airway clearance, which lead to increased risk of developing atelectasis, pneumonia and chronic respiratory insufficiency. [7][8][9] Therefore, the assessment of absolute and relative inspiratory and expiratory muscle impairment is of high clinical relevance. Veale et al 6 found a significant difference between P Imax and P Emax values in subjects with NMDs, namely facio-scapulo humoral dystrophy, limb girdle dystrophy, spinal muscular atrophy, mitochondrial myopathy, and polymyositis.…”

Section: Introductionmentioning

confidence: 99%

Muscle Impairment in Neuromuscular Disease Using an Expiratory/Inspiratory Pressure Ratio

et al. 2015

View full text Add to dashboard Cite

BACKGROUND: Neuromuscular diseases (NMDs) lead to different weakness patterns, and most patients with NMDs develop respiratory failure. Inspiratory and expiratory muscle strength can be measured by maximum static inspiratory pressure (P Imax ) and maximum static expiratory pressure (P Emax ), and the relationship between them has not been well described in healthy subjects and subjects with NMDs. Our aim was to assess expiratory/inspiratory muscle strength in NMDs and healthy subjects and calculate P Emax /P Imax ratio for these groups. METHODS: Seventy (35 males) subjects with NMDs (amyotrophic lateral sclerosis, myasthenia gravis, and myotonic dystrophy), and 93 (47 males) healthy individuals 20 -80 y of age were evaluated for anthropometry, pulmonary function, P Imax , and P Emax , respectively. RESULTS: Healthy individuals showed greater values for P Imax and P Emax when compared with subjects with NMDs. P Emax /P Imax ratio for healthy subjects was 1.31 ؎ 0.26, and P Emax %/P Imax % was 1.04 ؎ 0.05; for subjects with NMDs, P Emax /P Imax ratio was 1.45 ؎ 0.65, and P Emax %/P Imax % ratio was 1.42 ؎ 0.67. We found that P Emax %/P Imax % for myotonic dystrophy was 0.93 ؎ 0.24, for myasthenia gravis 1.94 ؎ 0.6, and for amyotrophic lateral sclerosis 1.33 ؎ 0.62 when we analyzed them separately. All healthy individuals showed higher P Emax compared with P Imax . For subjects with NMDs, the impairment of P Emax and P Imax is different among the 3 pathologies studied (P < .001). CONCLUSIONS: Healthy individuals and subjects with NMDs showed higher P Emax in comparison to P Imax regarding the P Emax /P Imax ratio. Based on the ratio, it is possible to state that NMDs show different patterns of respiratory muscle strength loss. P Emax /P Imax ratio is a useful parameter to assess the impairment of respiratory muscles in a patient and to customize rehabilitation and treatment.

show abstract

“…Some LGMD patients, however, experience chronic cough, dyspnoea on exertion, recurrent respiratory tract infections and signs of alveolar hypoventilation [10]. In BMD, cardiac involvement is the dominant feature and respiratory insufficiency is only rarely reported [11][12][13]. In FSHD pulmonary dysfunction tends to be mild and frequently associated with obstructive sleep apnea related to upper airway muscle weakness [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%