Molgat-Seon Yannick, Hannan Liam M, Dominelli Paolo B, Peters Carli M, Fougere Renee J, McKim Douglas A, Sheel A William, Road Jeremy D
School of Kinesiology, University of British Columbia, Vancouver, Canada.
Institute for Breathing and Sleep, Austin Hospital, Heidelberg, Australia; Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia.
ERJ Open Res. 2017 Mar 14;3(1). doi: 10.1183/23120541.00135-2016. eCollection 2017 Jan.
The aim of the present study was to determine whether lung volume recruitment (LVR) acutely increases respiratory system compliance () in individuals with severe respiratory muscle weakness (RMW). Individuals with RMW resulting from neuromuscular disease or quadriplegia (n=12) and healthy controls (n=12) underwent pulmonary function testing and the measurement of at baseline, immediately after, 1 h after and 2 h after a single standardised session of LVR. The LVR session involved 10 consecutive supramaximal lung inflations with a manual resuscitation bag to the highest tolerable mouth pressure or a maximum of 50 cmHO. Each LVR inflation was followed by brief breath-hold and a maximal expiration to residual volume. At baseline, individuals with RMW had lower than controls (37±5 cmHO 109±10 mL·cmHO, p<0.001). Immediately after LVR, increased by 39.5±9.8% to 50±7 mL·cmHO in individuals with RMW (p<0.05), while no significant change occurred in controls (p=0.23). At 1 h and 2 h post-treatment, there were no within-group differences in compared to baseline (all p>0.05). LVR had no significant effect on measures of pulmonary function at any time point in either group (all p>0.05). During inflations, mean arterial pressure decreased significantly relative to baseline by 10.4±2.8 mmHg and 17.3±3.0 mmHg in individuals with RMW and controls, respectively (both p<0.05). LVR acutely increases in individuals with RMW. However, the high airway pressures during inflations cause reductions in mean arterial pressure that should be considered when applying this technique.
本研究的目的是确定肺容积复张(LVR)是否能急性增加严重呼吸肌无力(RMW)个体的呼吸系统顺应性()。因神经肌肉疾病或四肢瘫痪导致RMW的个体(n = 12)和健康对照者(n = 12)在单次标准化LVR治疗前、治疗后即刻、治疗后1小时和2小时接受了肺功能测试并测量了。LVR治疗包括使用手动复苏袋以最高可耐受的口腔压力进行10次连续的超最大肺充气,或最大至50 cmH₂O。每次LVR充气后紧接着短暂屏气并最大呼气至残气量。基线时,RMW个体的低于对照组(37±5 cmH₂O 109±10 mL·cmH₂O,p<0.001)。LVR治疗后即刻,RMW个体的增加了39.5±9.8%,达到50±7 mL·cmH₂O(p<0.05),而对照组无显著变化(p = 0.23)。治疗后1小时和2小时,与基线相比,组内的无差异(所有p>0.05)。LVR在两组的任何时间点对肺功能指标均无显著影响(所有p>0.05)。充气过程中,RMW个体和对照组的平均动脉压相对于基线分别显著降低了10.4±2.8 mmHg和17.3±3.0 mmHg(均p<0.05)。LVR可急性增加RMW个体的。然而,充气过程中的高气道压力会导致平均动脉压降低,应用该技术时应予以考虑。