Hypodynamisk respirationsinsufficiens. Diagnostisk udredning
Engelsk titel: Hypodynamic respiratory insufficiency. Diagnostic investigation
Läs online
Författare:
Wiis J
;
Mortensen J
;
Jacobsen E
Språk: Dan
Antal referenser: 15
Dokumenttyp:
Översikt
UI-nummer: 03011811
Sammanfattning
Patients with restrictive lung disease, owing to respiratory muscle dysfunction, have no parenchymal involvement. Their vital capacity (VC) and total lung capacity ( TLC) are reduced to less than 50% and can lead to pneumonia and nocturnal hypercapnia and hypoxia. Their diffusion capacity is normal. With maximal static mouth pressure (Pimax) <80 cm H2O and/or Pemax <100 cm H2O, patients are referred to the national centres. Here, inspiratory muscular insufficiency is confirmed by sniff nasal inspiratory pressure and oesophageal pressure <70 cm H2O. Expiratory muscular insufficiency is confirmed by a cough peak flow <3-4 L/sec. and cough gastric pressure <100 cm H2O. Sleep studies reveal nocturnal hypoventilation. Phrenic nerve stimulation is to be introduced in the diagnostic approach. Twitch mouth or oesophageal pressure <10 cm H2O and twitch gastric pressure <7 cm H2O are pathognomonic for neuromuscular respiratory insufficiency.