Department of Respiratory Medicine, Royal Brompton & Harefield NHS Foundation Trust, Fulham Road, London SW3 6NP, UK.
Clin Chest Med. 2019 Jun;40(2):307-315. doi: 10.1016/j.ccm.2019.02.015.
Respiratory muscle weakness is relatively rare in clinical practice; therefore, it is seldom a clinician's first thought. However, it should always be considered where a patient has unexplained breathlessness, respiratory failure, or experiences difficulty weaning from mechanical ventilation. Diaphragm weakness can often be ruled out by careful application of history, examination, and noninvasive bedside tests, although more quantitative tests exist. Where the predominant problem is respiratory muscle weakness, these tests convey useful prognostic information, which can be used for the management of an individual patient and to enrich study populations allowing reduced sample size in clinical trials.
呼吸肌无力在临床上相对少见;因此,它很少是临床医生首先考虑的问题。然而,在患者出现不明原因的呼吸困难、呼吸衰竭或在机械通气脱机过程中出现困难时,应始终考虑呼吸肌无力的可能性。通过仔细应用病史、检查和非侵入性床边测试,通常可以排除膈肌无力,尽管存在更定量的测试。如果主要问题是呼吸肌无力,这些测试提供了有用的预后信息,可用于个体患者的管理,并丰富研究人群,使临床试验的样本量减少。