Respiratory Muscle Strength During and After Hospitalization for COPD Exacerbation

Abstract

BACKGROUND: A more profound investigation of respiratory muscle strength during COPD exacerbation was needed, so we investigated respiratory muscle strength and related factors in patients with COPD during and after hospitalization for COPD exacerbation. METHODS: In 19 subjects hospitalized for COPD exacerbation (12 males, mean age 67 ؎ 11 y, median percent-ofpredicted FEV 1 26% [IQR 19 -32%]) we measured lung function and respiratory and quadriceps muscle strength at admission (day 1), at discharge, and 1 month after discharge. RESULTS: At admission, 68% of the subjects had inspiratory muscle dysfunction (maximum inspiratory pressure < 70% of predicted O], P ‫؍‬ .001). Inspiratory capacity increased between discharge (1.59 ؎ 0.44 L) and 1 month after discharge (1.99 ؎ 0.54 L, P ‫؍‬ .02). There was no significant change in other lung function variables or quadriceps strength. At admission the inspiratory muscle dysfunction and reduction in inspiratory capacity (< 80% of predicted) correlated linearly (phi coefficient 0.62, P ‫؍‬ .03), whereas the expiratory muscle strength correlated inversely with FEV 1 (Spearman rho ؊0.61, P ‫؍‬ .005) and inspiratory capacity (Spearman rho ؊0.54, P ‫؍‬ .02). CONCLUSIONS: There was a high prevalence of inspiratory muscle dysfunction in patients hospitalized for COPD exacerbation. Inspiratory and expiratory muscle strength increased markedly during and after hospitalization. The degree of air-flow obstruction and hyperinflation were related to inspiratory and expiratory muscle strength.

The feasibility of early pulmonary rehabilitation and activity after COPD exacerbations: external pilot randomised controlled trial, qualitative case study and exploratory economic evaluation

“…This may be more convenient and less distressing for participants and may promote adherence. The intervention is structured in such a way as to initiate exercise training within 72 hours of hospital discharge, thereby limiting the physical deconditioning that occurs post exacerbation 198 while also allowing participants to take part in group rehabilitation 4-6 weeks post discharge so that training may be optimised while stable. The components of the intervention are based on current BTS 34 and American and European 197,199 PR guidelines.…”

Higher serum levels of systemic inflammatory markers are linked to greater inspiratory muscle dysfunction in COPD

“…Whereas respiratory muscle dysfunction is widely present in this population and reported to be even more prominent during exacerbations, little is known about the association between markers of systemic inflammation and the inspiratory muscle performance of affected individuals. Therefore, this study investigated the relationships among several inflammatory markers and inspiratory muscle function in subjects with COPD.…”

Muscle metabolomics analysis reveals potential biomarkers of exercise‑dependent improvement of the diaphragm function in chronic obstructive pulmonary disease

“…chronic obstructive pulmonary disease (cOPd) is becoming a significant cause of mortality and disability worldwide due to the aging population, the increasing number of smokers and worsening air pollution (1). Among the numerous symptoms of cOPd, the decline of the respiratory function is a crucial factor affecting the quality of life of patients (2), and the respiratory failure caused by respiratory muscle dysfunction is the most severe symptom of cOPd, given that respiratory failure is closely related to the mortality rate of patients with COPD. The maximum inspiratory pressure, which is closely associated with the function of inspiratory muscle, also represents one of the independent factors affecting the survival rate of these patients (3).…”