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."
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.
Review of VC and P (imax) of all patients hospitalized in ICU for Guillain-Barré syndrome (GBS) and myasthenia gravis (MG) exacerbation.
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.
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.
Physiologie-Explorations Fonctionnelles, Service de Réanimation Médicale, et Centre d'Innovations Technologiques UMR 805, Hôpital Raymond Poincaré, AP-HP, 92380, Garches, France.
This article was published in the following journal.
Name: Neurocritical care
- 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.
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.
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.
The purpose of this study was to determine if serum levels of skeletal troponin I (sTnI, fast and slow isoforms) could provide a sensitive marker of respiratory muscle damage in healthy humans subject...
A meta-analysis including 32 randomised controlled trials on the effects of inspiratory muscle training (IMT) in chronic obstructive pulmonary disease (COPD) patients was performed. Overall and subgro...
BACKGROUND: The aim of the study was to compare the effects of conventional posterolateral thoracotomy and muscle-sparing posterolateral thoracotomy on pulmonary and muscle strength. METHODS: From Jan...
OBJECTIVES: A test of the hypothesis that upper airway resistance syndrome (UARS) patients have an increased prevalence of inspiratory airflow limitation (IFL) during sleep compared to healthy control...
PURPOSE: The purpose of this study was to examine changes in the prevalence of exercise intolerance, reduced muscle strength, and fatigue and the changes in these parameters in individual patients dur...
Hypothesis:benefits of inspiratory muscle strenght training with Respifit S decreases symptoms, disability or handicap of patients affected by COPD. The inspiratory fraction (inspiratory...
Spirometry testing should include both expiratory and inspiratory measurements as it may influence the expiratory flow volume curve indices. The ability to inhale medication may by judged...
The purpose of this study is to assess the change in inspiratory capacity and lung function in patients with chronic obstructive pulmonary disease when treated with indacaterol compared to...
Preoxygenation optimizes oxygen content in the functional residual capacity (FRC). Adequate preoxygenation is defined by an expiratory oxygen fraction (FEO2) > 90%. Inspiratory support and...
We will detect dynamic hyperinflation (DH)in 40 COPD patients with moderately severe disease using metronome paced hyperventilation (MPH) with inspiratory capacity as the primary end point...