Noninvasive Determination of the Tension-Time Index in Duchenne Muscular Dystrophy

Hahn, Andreas; Duisberg, Barbara; Neubauer, Bernd A.; Stephani, Ulrich; Rideau, Y

doi:10.1097/phm.0b013e3181909dfa

Cited by 14 publications

(17 citation statements)

References 16 publications

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“…24 reported that VC > 1820 ml resulted to be the best discriminator for sleep-related hypercapnia. Dedicated indexes such as non invasive Tension-Time Index, 29 Breathing Intolerance Index (BITI) 8 and Ventilator Requirement Index (VRI) 7 have been recently proposed to discriminate those patients with neuromuscular disease at risks for respiratory muscle fatigue approaching the need for assisted ventilation.…”

Section: Discussionmentioning

confidence: 99%

Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy

Romei

D’Angelo

LoMauro

et al. 2012

Respiratory Medicine

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In the respiratory management of DMD patients it is still under debate what parameter should indicate the correct timing for institution of nocturnal non-invasive ventilation (NIV), in addition to forced vital capacity, which is generally considered as a prognostic marker of disease progression. The aim of this study was to determine if volume variations of rib cage and abdominal compartments measured by Opto-Electronic Plethysmography can be helpful to distinguish between those patients who are in the early stages of nocturnal oxygen desaturation development and those who do not yet. Pulmonary function, abdominal contribution to tidal volume and to inspiratory capacity (%Abd IC) and a set of breathing pattern indexes were assessed in 40 DMD patients older than 14 years and not yet under nocturnal NIV. ROC analysis revealed that among all the considered parameters, %Abd IC in supine position was the best discriminator between DeSat (at least 10% of the night time with SpO(2) < 95%) and NonDeSat patients, providing an area under the curve with 95%CI equal to 0.752. In conclusion, in adolescents and adults DMD patients who present either no sign or only mild nocturnal oxygen desaturation, a reduced abdominal contribution to inspiratory capacity is a marker of the onset of diaphragm weakness and should be considered to identify the correct timing for the institution of nocturnal NIV.

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Section: Discussionmentioning

confidence: 99%

Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy

Romei

D’Angelo

LoMauro

et al. 2012

Respiratory Medicine

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“…For example, studies demonstrate that T T0.1 increases with disease progression in boys with Duchenne muscular dystrophy [31] and decreases after use of noninvasive ventilation as a measure of inspiratory muscle unloading [32]. Follow-up of respiratory muscle tests in children and adolescents should include noninvasive T T0.1 determinations for assessment of disease progression.…”

Section: Discussionmentioning

confidence: 99%

Reference Values for Respiratory Muscle Strength in Children and Adolescents

et al. 2018

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Background: Measurement of respiratory muscle function is important in the diagnosis of respiratory muscle disease, respiratory failure, to assess the impact of chronic diseases, and/or to evaluate respiratory muscle function after treatment. Objectives: To establish reference values for maximal inspiratory and expiratory pressure, and the tension-time index at rest in healthy children and adolescents aged 8–19 years, as well as to present sex- and age-related reference centiles normalized for demographic and anthropometric determinants. Methods: In this cross-sectional observational study, demographic, anthropometric, and spirometric data were assessed, as well as data on respiratory muscle strength (P_Imax and P_Emax) and work of breathing at rest (T_T0.1), in a total of 251 children (117 boys and 134 girls; mean age 13.4 ± 2.9 years). Reference values are presented as reference centiles developed by use of the lambda, mu, sigma method. Results: Boys had significantly higher P_Imax and P_Emax values. Next to sex and age, fat-free mass appeared to be an important predictor of respiratory muscle strength. Reference centiles demonstrated a slight, almost linear increase in P_Imax with age in boys, and a less steep increase with age in girls. T_T0.1 values did not differ between boys and girls and decreased linearly with age. Conclusion: This study provides reference values for respiratory muscle strength and work of breathing at rest. In addition to sex and age, fat-free mass was found to be an important predictor of respiratory muscle strength in boys and girls.

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“…An inspiratory hold of 2 s was used to record the plateau pressure (P plat ), and the static C RS was calculated by dividing the V T by the difference between the inspiratory P plat and PEEP: static C RS ϭ V T /P plat Ϫ PEEP). 16,19 TT mus is obtained noninvasively and assesses the inspiratory muscle function by the following equation: TT mus ϭ (P I /P Imax(UV) ) ϫ (T I /T tot ), where P I is inspiratory pressure estimated as 5 ϫ P 0.1 ϫ T I , 25,26 T I is inspiratory time, and T tot is the total respiratory cycle time obtained from the mechanical ventilation parameters during the testing period. 14,17,25,26 The TIE index was recorded using the unidirectional valve method and calculated as the ratio between P Imax(UV) and the corresponding time to achieve it in 60 s of observation.…”

Section: What This Paper Contributes To Our Knowledgementioning

confidence: 99%

The Timed Inspiratory Effort: A Promising Index of Mechanical Ventilation Weaning for Patients With Neurologic or Neuromuscular Diseases

Souza¹,

Guimarães

Lugon

2014

Respiratory Care

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Noninvasive Determination of the Tension-Time Index in Duchenne Muscular Dystrophy

Cited by 14 publications

References 16 publications

Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy

Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy

Reference Values for Respiratory Muscle Strength in Children and Adolescents

The Timed Inspiratory Effort: A Promising Index of Mechanical Ventilation Weaning for Patients With Neurologic or Neuromuscular Diseases

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