scholarly journals Respiratory Muscle Aids in the Management of Neuromuscular Respiratory Impairment to Prevent Respiratory Failure and Need for Tracheostomy

10.5772/34907 ◽  
2012 ◽  
Author(s):  
A. J. ◽  
J. R.
Keyword(s):  
Respiratory Failure ◽  
Respiratory Muscle ◽  
Respiratory Impairment

The Truncated Splice Variant of the Granulocyte-Macrophage-Colony-Stimulating Factor Receptor β- Chain in Peripheral Blood Serves as Severity Biomarker of Respiratory Failure in Newborns

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Verena Schulte ◽  
Alexandra Sipol ◽  
Stefan Burdach ◽  
Esther Rieger-Fackeldey
Keyword(s):  
Respiratory Failure ◽  
Peripheral Blood ◽  
Colony Stimulating Factor ◽  
Term Infants ◽  
Respiratory Impairment ◽  
Gm Csf ◽  
A Subunit ◽  
Macrophage Colony Stimulating Factor ◽  
Macrophage Colony ◽  
Stimulating Factor

<b><i>Background:</i></b> The granulocyte-macrophage-colony-stimulating factor (GM-CSF) plays an important role in surfactant homeostasis. β<sub>C</sub> is a subunit of the GM-CSF receptor (GM-CSF-R), and its activation mediates surfactant catabolism in the lung. β<sub>IT</sub> is a physiological, truncated isoform of β<sub>C</sub> and is known to act as physiological inhibitor of β<sub>C</sub>. <b><i>Objective:</i></b> The aim of this study was to determine the ratio of β<sub>IT</sub> and β<sub>C</sub> in the peripheral blood of newborns and its association with the degree of respiratory failure at birth. <b><i>Methods:</i></b> We conducted a prospective cohort study in newborns with various degrees of respiratory impairment at birth. Respiratory status was assessed by a score ranging from no respiratory impairment (0) to invasive respiratory support (3). β<sub>IT</sub> and β<sub>C</sub> expression were determined in peripheral blood cells by real-time PCR. β<sub>IT</sub> expression, defined as the ratio of β<sub>IT</sub> and β<sub>C</sub>, was correlated with the respiratory score. <b><i>Results:</i></b> β<sub>IT</sub> expression was found in all 59 recruited newborns with a trend toward higher β<sub>IT</sub> in respiratory ill (score 2, 3) newborns than respiratory healthy newborns ([score 0, 1]; <i>p</i> = 0.066). Seriously ill newborns (score 3) had significantly higher β<sub>IT</sub> than healthy newborns ([score 0], <i>p</i> = 0.010). Healthy preterm infants had significantly higher β<sub>IT</sub> expression than healthy term infants (<i>p</i> = 0.019). <b><i>Conclusions:</i></b> β<sub>IT</sub> is expressed in newborns with higher expression in respiratory ill than respiratory healthy newborns. We hypothesize that β<sub>IT</sub> may have a protective effect in postnatal pulmonary adaptation acting as a physiological inhibitor of β<sub>C</sub> and, therefore, maintaining surfactant in respiratory ill newborns.

Noninvasive measurement of the tension-time index in children with neuromuscular disease

2003 ◽  
Vol 95 (3) ◽  
pp. 931-937 ◽  
Author(s):  
Laura T. Mulreany ◽  
Daniel J. Weiner ◽  
Joseph M. McDonough ◽  
Howard B. Panitch ◽  
Julian L. Allen
Keyword(s):  
Respiratory Failure ◽  
Muscle Fatigue ◽  
Neuromuscular Disease ◽  
Respiratory Muscle ◽  
Forced Expiratory Volume ◽  
Inspiratory Pressure ◽  
Maximal Inspiratory Pressure ◽  
Respiratory Muscle Fatigue ◽  
Time Index ◽  
Tension Time

Respiratory muscle weakness is common in children with neuromuscular disease (NMD). We hypothesized that weakness puts them at risk for respiratory muscle fatigue, a harbinger of chronic respiratory failure. We therefore measured a noninvasive index of respiratory muscle fatigue, the tension-time index of the respiratory muscles (TTmus), in 11 children with NMD and 13 control subjects. Spirometric flow rates and maximal inspiratory pressure were significantly lower in the NMD group than in controls (43 ± 23 vs. 99 ± 21 cmH2O, P < 0.001). The mean TTmus was significantly higher in the NMD group than in controls (0.205 ± 0.117 vs. 0.054 ± 0.021, P < 0.001). The increase in TTmus was primarily due to an increase in the ratio of average mean inspiratory pressure to maximal inspiratory pressure, indicating decreased respiratory muscle strength reserve. We found a significant correlation between TTmus and the residual volume-to-total lung capacity ratio ( r = 0.504, P = 0.03) and a negative correlation between TTmus and forced expiratory volume in 1 s ( r = -0.704, P < 0.001). In conclusion, children with NMD are prone to respiratory muscle fatigue. TTmus may be useful in assessing tolerance during weaning from mechanical ventilation, identifying impending respiratory failure, and aiding in the decision to institute therapies.

scholarly journals Cortical drive to breathe in amyotrophic lateral sclerosis: a dyspnoea-worsening defence?

2016 ◽  
Vol 47 (6) ◽  
pp. 1818-1828 ◽  
Author(s):  
Marjolaine Georges ◽  
Elise Morawiec ◽  
Mathieu Raux ◽  
Jésus Gonzalez-Bermejo ◽  
Pierre-François Pradat ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Respiratory Failure ◽  
Spontaneous Breathing ◽  
Neck Muscle ◽  
Compensatory Mechanism ◽  
Respiratory Impairment ◽  
Als Patients ◽  
Lateral Sclerosis ◽  
Diaphragm Weakness ◽  
Severe Dyspnoea

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease causing diaphragm weakness that can be partially compensated by inspiratory neck muscle recruitment. This disappears during sleep, which is compatible with a cortical contribution to the drive to breathe. We hypothesised that ALS patients with respiratory failure exhibit respiratory-related cortical activity, relieved by noninvasive ventilation (NIV) and related to dyspnoea.We studied 14 ALS patients with respiratory failure. Electroencephalographic recordings (EEGs) and electromyographic recordings of inspiratory neck muscles were performed during spontaneous breathing and NIV. Dyspnoea was evaluated using the Multidimensional Dyspnea Profile.Eight patients exhibited slow EEG negativities preceding inspiration (pre-inspiratory potentials) during spontaneous breathing. Pre-inspiratory potentials were attenuated during NIV (p=0.04). Patients without pre-inspiratory potentials presented more advanced forms of ALS and more severe respiratory impairment, but less severe dyspnoea. Patients with pre-inspiratory potentials had stronger inspiratory neck muscle activation and more severe dyspnoea during spontaneous breathing.ALS-related diaphragm weakness can engage cortical resources to augment the neural drive to breathe. This might reflect a compensatory mechanism, with the intensity of dyspnoea a negative consequence. Disease progression and the corresponding neural loss could abolish this phenomenon. A putative cognitive cost should be investigated.

Respiratory Disorders in Parkinson’s Disease

2021 ◽  
pp. 1-18
Author(s):  
Evelyn M. Guilherme ◽  
Roberta de Fátima C.M. Padovez ◽  
Adriele de Oliveira ◽  
Alyne Montero Ferro ◽  
Valéria A. P. di Lorenzo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Muscle Strength ◽  
Pulmonary Function ◽  
Respiratory Muscle ◽  
Physical Capacity ◽  
Respiratory Muscle Strength ◽  
Respiratory Impairment ◽  
Respiratory Disorders ◽  
Electronic Search

Background: Parkinson’s disease (PD) non motor symptoms may present early in the disease course and worsen with advancing disease. Respiratory changes can affect individuals to remain physically active, contributing to a reductionof functionality and quality of life. Objective: The aim of this systematic review is to synthesize evidence of respiratory disorders in patients with PD. Methods: An electronic search was performed up to November 2020 on PubMed-MEDLINE, Embase, Web of Science, Lilacs, Cinahl, and Cochrane using the following keyword combination: [(“Parkinson disease”) AND (“respiratory function tests” OR “evaluation”) AND (“respiratory system” OR “respiration disorders” OR “respiratory muscles”)]. Results: The electronic search resulted in 601 references in English or Portuguese. The selection process and data extraction were made by two independent reviewers. We selected 19 studies including cross-sectional studies that investigated the respiratory disorders in patients with PD through pulmonary function, respiratory muscle strength, or physical capacity evaluation. We excluded studies that considered patients with other diseases. Eighteen studies evaluated the pulmonary function in patients with PD, eleven studies verified the influence of PD on respiratory muscle strength, and three studies assessed the physical capacity through functional tests. Conclusion: The evidence showed that PD patients have higher chances to present a pulmonary dysfunction, either obstructive or restrictive, when compared to healthy subjects. In addition, these patients present lower respiratory muscle strength and a consequent decrease in physical capacity in endurance exercises. The respiratory impairment in PD seems to be directly related to the progression of the disease.

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