Gigliotti F, Duranti R, Fabiani A, Schiavina M, Scano G
Istituto di Clinica Medica III, Università degli Studi, Florence, Italy.
Chest. 1991 May;99(5):1186-92. doi: 10.1378/chest.99.5.1186.
We evaluated the ability of NPV to suppress EMGd and EMGint in seven patients with severe COPD and five normal subjects. Subjects were studied either without (A) or with mouthpiece and nose clip (B). Electromyographic suppression was assessed comparing EMG activity during NPV with the control activity without a mouthpiece and prior to the initiation of the NPV run. In normal subjects, in A, NPV resulted in a partial suppression of EMGd; in B, prior to NPV, EMGd rose compared with A prior to NPV. In patients, in A, NPV resulted in a suppression of both EMGd and EMGint. In B, prior to NPV, both EMGd and EMGint rose compared with A prior to NPV. Thus, it seems that NPV is able to produce a consistent reduction in inspiratory muscle EMG activity. This variable NPV ability would have to be assessed for better selection criteria for patient candidates in a rehabilitation program.
我们评估了无创通气(NPV)对7例重度慢性阻塞性肺疾病(COPD)患者和5名正常受试者的膈肌肌电图(EMGd)和肋间肌肌电图(EMGint)的抑制能力。受试者在无(A组)或使用咬嘴和鼻夹(B组)的情况下接受研究。通过比较无创通气期间的肌电图活动与无咬嘴且在无创通气开始前的对照活动来评估肌电图抑制情况。在正常受试者中,在A组,无创通气导致膈肌肌电图部分抑制;在B组,在无创通气前,与A组无创通气前相比,膈肌肌电图升高。在患者中,在A组,无创通气导致膈肌肌电图和肋间肌肌电图均受到抑制。在B组,在无创通气前,与A组无创通气前相比,膈肌肌电图和肋间肌肌电图均升高。因此,似乎无创通气能够使吸气肌肌电图活动持续降低。为了在康复计划中更好地选择患者候选人,必须评估这种无创通气能力的可变性。