Low abdominal contribution to breathing as daytime predictor of nocturnal desaturation in adolescents and young adults with Duchenne Muscular Dystrophy - 23/12/11
Corresponding author. Tel.: +39 02 2399 9006.Summary |
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 SpO2 < 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.
Le texte complet de cet article est disponible en PDF.Keywords : Abdomen, Diaphragm, Duchenne Muscular Dystrophy, Nocturnal hypoxemia
Plan
Vol 106 - N° 2
P. 276-283 - février 2012 Retour au numéro
Article précédent
- Testosterone and resistance training effects on muscle nitric oxide synthase isoforms in COPD men
- Bahman Chavoshan, Mario Fournier, Michael I. Lewis, Janos Porszasz, Thomas W. Storer, Xiaoyu Da, Mehdi Rambod, Richard Casaburi
- Direct evidence that GM-CSF inhalation improves lung clearance in pulmonary alveolar proteinosis
- Kazumasa Ohashi, Atsuyasu Sato, Toshinori Takada, Toru Arai, Takahito Nei, Yasunori Kasahara, Natsuki Motoi, Masayuki Hojo, Shinya Urano, Haruyuki Ishii, Masanori Yokoba, Ryosuke Eda, Hideaki Nakayama, Yasuyuki Nasuhara, Yoshiko Tsuchihashi, Chinatsu Kaneko, Hiroko Kanazawa, Masahito Ebina, Etsuro Yamaguchi, Jacqueline Kirchner, Yoshikazu Inoue, Koh Nakata, Ryushi Tazawa
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?