Vital Capacity Versus Maximal Inspiratory Pressure in Patients with Guillain-Barré Syndrome and Myasthenia Gravis.
Summary of "Vital Capacity Versus Maximal Inspiratory Pressure in Patients with Guillain-Barré Syndrome and Myasthenia Gravis."
BACKGROUND:
The objective is to determine whether maximal inspiratory pressure (P (imax)) measurement is more sensitive than vital capacity (VC) measurement to detect acute respiratory muscle failure considering a theoretical curvilinear relationship between volume and pressure.
METHODS:
Review of VC and P (imax) of all patients hospitalized in ICU for Guillain-Barré syndrome (GBS) and myasthenia gravis (MG) exacerbation.
RESULTS:
84 consecutive caucasian patients between 19- and 70-years-old hospitalized in intensive care unit from April 2008 to December 2010, for MG exacerbation (44 patients) and GBS (40 patients). The regression curve between VC and P (imax) was linear rather than exponential (r = 0.599, P > 0.0001). The contingency table demonstrated agreement between VC and P (imax) (χ(2 )= 26.7, P = 0.0001), with similar number of patients having abnormal P (imax) associated to normal VC and normal P (imax) associated to abnormal VC (9 (10.7%) vs. 8 (9.5%) respectively). Six of the patients developed an important decrease of VC from normal value to less than 60% of the predicted value and did not present evident curvilinear relationship between VC and P (imax) during this follow-up.
CONCLUSIONS:
Because the regression between VC and P (imax) was linear rather than curvilinear, P (imax) was not more sensitive than VC for early detection of respiratory muscle failure in patients hospitalized in ICU for GBS and MG exacerbation. Therefore, VC remains well suited to assess acute respiratory muscle failure and P (imax) gives poor additional information.
Affiliation
Physiologie-Explorations Fonctionnelles, Service de Réanimation Médicale, et Centre d'Innovations Technologiques UMR 805, Hôpital Raymond Poincaré, AP-HP, 92380, Garches, France.
Journal Details
This article was published in the following journal.
Name: Neurocritical care
ISSN: 1556-0961
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21748507
- DOI: http://dx.doi.org/10.1007/s12028-011-9575-y
Medical and Biotech [MESH] Definitions
Total Lung Capacity
The volume of air contained in the lungs at the end of a maximal inspiration. It is the equivalent to each of the following sums: VITAL CAPACITY plus RESIDUAL VOLUME; INSPIRATORY CAPACITY plus FUNCTIONAL RESIDUAL CAPACITY; TIDAL VOLUME plus INSPIRATORY RESERVE VOLUME plus functional residual capacity; or tidal volume plus inspiratory reserve volume plus EXPIRATORY RESERVE VOLUME plus residual volume.
Maximal Expiratory Flow-volume Curves
Curves depicting MAXIMAL EXPIRATORY FLOW RATE, in liters/second, versus lung inflation, in liters or percentage of lung capacity, during a FORCED VITAL CAPACITY determination. Common abbreviation is MEFV.
Vital Capacity
The volume of air that is exhaled by a maximal expiration following a maximal inspiration.
Maximal Expiratory Flow Rate
The airflow rate measured during the first liter expired after the first 200 ml have been exhausted during a FORCED VITAL CAPACITY determination. Common abbreviations are MEFR, FEF 200-1200, and FEF 0.2-1.2.
Inspiratory Capacity
The maximum volume of air that can be inspired after reaching the end of a normal, quiet expiration. It is the sum of the TIDAL VOLUME and the INSPIRATORY RESERVE VOLUME. Common abbreviation is IC.
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