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Effect of surgical lung volume reduction on respiratory muscle function in pulmonary emphysema
- Source :
- The European respiratory journal. 9(9)
- Publication Year :
- 1996
-
Abstract
- Lung volume reduction surgery (LVRS) in patients with severe lung emphysema restores the thoracic configuration to a more normal functional capacity. The aim of this study was to investigate whether reduction in intrathoracic volume by LVRS improves the inspiratory muscle force generation of the respiratory pump. Pulmonary function tests, maximal inspiratory mouth pressure (MIP), sniff nasal inspiratory pressure (SNIP), sniff transdiaphragmatic pressure (Pdi), and inspiratory mouth occlusion pressure (P0.1) were measured in 17 emphysematous patients (mean (+/- SEM) age 53 +/- 2 yrs) before and 1 month after LVRS. The mean value of forced expiratory volume in one second (FEV1) increased (0.82 +/- 0.07 vs 1.12 +/- 0.08 L; p < 0.0001), whilst there was a decrease (p < 0.0001) in residual volume (RV) (337 +/- 31 vs 250 +/- 21 % of predicted), functional residual capacity (FRC) (210 +/- 9 vs 159 +/- 9% pred), and total lung capacity (TLC) (138 +/- 6 vs 110 +/- 5% pred). The mean value of MIP increased by 52% from 4.8 +/- 0.4 to 7.3 +/- 0.6 kPa (p < 0.001), the mean value of SNIP increased by 66% from 3.9 +/- 0.4 to 6.5 +/- 0.5 kPa (p < 0.001), and the mean value of Pdi increased by 28% from 6.0 +/- 0.6 to 7.7 +/- 0.8 kPa (p < 0.05) after LVRS. P0.1 decreased on average by 24% from 0.46 +/- 0.03 to 0.35 +/- 0.02 kPa after LVRS. No significant correlations were found between inspiratory muscle (MIP, SNIP, Pdi) and respiratory drive (P0.1) indices, lung function data, 6 min walk distance, or dyspnoea score. In conclusion, the observed clinical improvement of patients with severe emphysema after lung volume reduction surgery results, in part, from an increased ability of the inspiratory muscles to generate force, which is paralleled by a significant decrease in central respiratory drive.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Male
Functional Residual Capacity
Diaphragm
Walking
Lung volume reduction surgery
Nose
Pulmonary function testing
Functional residual capacity
Forced Expiratory Volume
Respiratory muscle
Pressure
Medicine
Humans
Lung emphysema
Lung volumes
Respiratory system
Pneumonectomy
Mouth
Lung
business.industry
Total Lung Capacity
Middle Aged
Thorax
Respiratory Muscles
respiratory tract diseases
Residual Volume
medicine.anatomical_structure
Dyspnea
Inhalation
Pulmonary Emphysema
Anesthesia
Respiratory Mechanics
Female
business
Subjects
Details
- ISSN :
- 09031936
- Volume :
- 9
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- The European respiratory journal
- Accession number :
- edsair.doi.dedup.....4808ea961c702bea1275f0451a01587f