Noninvasive determination of the tension-time index in Duchenne muscular dystrophy
| Autor: | Andreas Hahn, Bernd A. Neubauer, Barbara Duisberg, Ulrich Stephani, Yves Rideau |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Neuromuscular disease Time Factors Adolescent medicine.medical_treatment Duchenne muscular dystrophy Vital Capacity Physical Therapy Sports Therapy and Rehabilitation Severity of Illness Index Internal medicine Forced Expiratory Volume medicine Respiratory muscle Humans In patient Mechanical ventilation business.industry Rehabilitation Inspiratory muscle medicine.disease Surgery Muscular Dystrophy Duchenne Inhalation Time index Case-Control Studies Muscle Tonus Muscle Fatigue Breathing Cardiology Disease Progression business Lung Volume Measurements Respiratory Insufficiency |
| Zdroj: | American journal of physical medicinerehabilitation. 88(4) |
| ISSN: | 1537-7385 |
| Popis: | Noninvasive determination of the tension-time index of the inspiratory muscles (TT MUS) can identify predisposition to respiratory muscle fatigue in neuromuscular disease. We correlated TT MUS with age and extent of need of ventilator use for patients with Duchenne muscular dystrophy.Maximal inspiratory pressure, inspiratory pressure 0.1 sec after the onset of inspiration (P 0.1), and the breathing pattern during spontaneous breathing were measured in 46 subjects with Duchenne muscular dystrophy and in 46 healthy males of the same age. TT MUS (TT MUS = T I/T TOT x P I/MIP) was determined by calculating P I from P 0.1 (P I = 5 x P 0.1 x T I). The data were compared with normal values and related to age and ventilator use.TT MUS was significantly higher in the entire Duchenne muscular dystrophy group than in controls (0.21 +/- 0.11 vs. 0.06 +/- 0.02, P0.001) and increased with age in the patients (P0.001). TT MUS was significantly higher in subjects ventilated 8-20 hrs per day than in nocturnal-only users and in patients ventilated20 hrs per day than in those ventilated 8-20 hrs per day (P0.001). TT MUS surpassed 0.23 in 95% of subjects ventilated 8-20 hrs. TT MUS exceeded 0.37 in 95% of individuals ventilated20 hrs per day, whereas it was less than this value in 95% of patients ventilated 8-20 hrs.TT MUS increases significantly with disease progression and is a sensitive indicator of risk of inspiratory muscle fatigue and ventilator use. Longitudinal determination of TT MUS in patients with Duchenne muscular dystrophy may help to justify the extent of need for mechanical ventilation. |
| Databáze: | OpenAIRE |
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