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[PMID]:28633275
[Au] Autor:Shinohara S; Yamada T; Ueda M; Ishinagi H; Matsuoka T; Nagai S; Matsuoka K; Miyamoto Y
[Ad] Endereço:Department of Thoracic Surgery, National Hospital Organization Himeji Medical Center, Himeji, Japan. Electronic address: musictiger617@gmail.com.
[Ti] Título:Phrenic Nerve Reconstruction and Bilateral Diaphragm Plication After Lobectomy.
[So] Source:Ann Thorac Surg;104(1):e9-e11, 2017 Jul.
[Is] ISSN:1552-6259
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:A 49-year-old man with left phrenic nerve paralysis caused by mediastinal tumor resection 28 years earlier was found to have a nodule in the right upper lobe. The right phrenic nerve was severed during right upper lobectomy but was reconstructed along with bilateral plication of the diaphragm. The patient was weaned from the ventilator during the daytime on postoperative day 13 and was discharged home on postoperative day 48. Three months postoperatively, chest fluoroscopic imaging showed recovery of movement of the right diaphragm. Nerve conduction studies showed improvement of function of the reconstructed right phrenic nerve.
[Mh] Termos MeSH primário: Diafragma/cirurgia
Neoplasias Pulmonares/cirurgia
Doenças do Sistema Nervoso Periférico/cirurgia
Nervo Frênico/cirurgia
Pneumonectomia/efeitos adversos
Procedimentos Cirúrgicos Reconstrutivos/métodos
Paralisia Respiratória/cirurgia
[Mh] Termos MeSH secundário: Carcinoma Pulmonar de Células não Pequenas/diagnóstico
Carcinoma Pulmonar de Células não Pequenas/cirurgia
Diafragma/inervação
Seres Humanos
Neoplasias Pulmonares/diagnóstico
Masculino
Meia-Idade
Doenças do Sistema Nervoso Periférico/complicações
Doenças do Sistema Nervoso Periférico/diagnóstico
Nervo Frênico/lesões
Radiografia Torácica
Paralisia Respiratória/diagnóstico
Paralisia Respiratória/etiologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE


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[PMID]:28609340
[Au] Autor:Melton MS; Monroe HE; Qi W; Lewis SL; Nielsen KC; Klein SM
[Ad] Endereço:From the Departments of *Anesthesiology and †Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
[Ti] Título:Effect of Interscalene Brachial Plexus Block on the Pulmonary Function of Obese Patients: A Prospective, Observational Cohort Study.
[So] Source:Anesth Analg;125(1):313-319, 2017 Jul.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The effect of interscalene block (ISB) on pulmonary function of obese participants has not been investigated. The goal of this study is to assess the association of obesity (body mass index [BMI] >29 kg/m vs BMI <25 kg/m) and change in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) after ISB in participants undergoing outpatient shoulder surgery. METHODS: This prospective, observational cohort study compared obese (BMI >29 kg/m) and normal-weight (BMI <25 kg/m) groups undergoing ISB for ambulatory shoulder surgery, on preblock and postblock FVC and FEV1, at 30 minutes postblock and in the postanesthesia care unit (PACU). The primary outcome in this study was FVC% change (percentage change from preblock to postblock values of FVC) at 30 minutes postblock in the supine position. Secondary outcomes included FVC% change at PACU and in the sitting position, FEV1% change (percentage change from preblock to postblock values of FEV1), FVC, FEV1, incidence of diaphragmatic paresis, modified Borg scale for perceived dyspnea, Richmond Agitation-Sedation Scale scores for sedation, and intraoperative airway events. RESULTS: Fourteen participants were recruited to each group. The mean (standard deviation) BMI in the normal-weight and obese groups was 23 (1.7) and 33 (3.1) kg/m, respectively. ISB success rate was 100%. All participants demonstrated hemidiaphragmatic paresis after ISB. Compared to the normal-weight group, in the sitting position, the obese group had a significant decrease in FVC% change at 30 minutes (-30 [10.5] vs -23 [7.2], P = .046) and an FEV1% change in the PACU (-40 [12.6] vs -27 [13.9], P = .02). No difference was found for measurements taken in the supine position. A repeated-measures analysis demonstrated that, adjusted for position, there is no significant group effect on FVC% change or FEV1% change from 30 minutes to PACU. The 2 groups were not different in terms of breathlessness and sedation at 30 minutes (P = .67, P = .48, respectively) and in the PACU (P = .69, P > .99, respectively) nor in the occurrence of intraoperative airway events (P > .99). CONCLUSIONS: ISB is associated with greater FVC and FEV1 reductions in obese participants undergoing shoulder surgery compared to normal-weight participants. Neither time (30 minutes versus PACU) nor position (sitting versus supine) affected this relationship. Despite these changes, obesity was not associated with increased clinical respiratory symptoms or events.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Ambulatórios/efeitos adversos
Bloqueio do Plexo Braquial/efeitos adversos
Pulmão/fisiopatologia
Obesidade/complicações
Paralisia Respiratória/etiologia
Ombro/cirurgia
[Mh] Termos MeSH secundário: Adulto
Período de Recuperação da Anestesia
Índice de Massa Corporal
Feminino
Volume Expiratório Forçado
Seres Humanos
Masculino
Meia-Idade
Obesidade/diagnóstico
Obesidade/fisiopatologia
Posicionamento do Paciente
Estudos Prospectivos
Recuperação de Função Fisiológica
Paralisia Respiratória/diagnóstico
Paralisia Respiratória/fisiopatologia
Fatores de Risco
Ombro/inervação
Decúbito Dorsal
Fatores de Tempo
Resultado do Tratamento
Capacidade Vital
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002180


  3 / 1557 MEDLINE  
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[PMID]:28572225
[Au] Autor:Keelan E; Kidney J; Judge EP
[Ad] Endereço:Belfast City Hospital, Belfast, UK ekeelan01@qub.ac.uk.
[Ti] Título:An unusual case of orthopnea.
[So] Source:Clin Med (Lond);17(3):245-247, 2017 Jun.
[Is] ISSN:1473-4893
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Bilateral diaphragmatic paralysis is a known cause of respiratory failure. Diagnosis can be difficult, particularly in the acute setting. We present the case of a gentleman diagnosed with bilateral diaphragmatic paralysis secondary to phrenic neuropathy in the setting of cervical spondylosis.
[Mh] Termos MeSH primário: Dispneia
Doenças do Sistema Nervoso Periférico
Nervo Frênico/fisiopatologia
Paralisia Respiratória
[Mh] Termos MeSH secundário: Medula Cervical/diagnóstico por imagem
Diagnóstico Diferencial
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Radiografia Torácica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170603
[St] Status:MEDLINE
[do] DOI:10.7861/clinmedicine.17-3-245


  4 / 1557 MEDLINE  
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[PMID]:28441238
[Au] Autor:Reynolds S; Ebner A; Meffen T; Thakkar V; Gani M; Taylor K; Clark L; Sadarangani G; Meyyappan R; Sandoval R; Rohrs E; Hoffer JA
[Ad] Endereço:1Critical Care Department, Fraser Health Authority, New Westminster, BC, Canada.2Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.3Cardiovascular Department, Sanatorio Italiano, Asunción, Paraguay.4Lungpacer Medical Inc., Burnaby, BC, Canada.
[Ti] Título:Diaphragm Activation in Ventilated Patients Using a Novel Transvenous Phrenic Nerve Pacing Catheter.
[So] Source:Crit Care Med;45(7):e691-e694, 2017 Jul.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach. DESIGN: First-in-Humans case series. SETTING: Angiogram suite. PATIENTS: Twenty-four sedated, mechanically ventilated patients immediately prior to an elective atrial septal defect repair procedure. INTERVENTIONS: A 9.5-Fr central venous catheter with 19 embedded electrodes was placed via Seldinger technique into the left subclavian vein and superior vena cava and evaluated for up to 90 minutes. The electrode combinations determined to provide best transvenous stimulation of the right and left phrenic nerves were activated in synchrony with mechanically ventilated breaths. MEASUREMENTS AND MAIN RESULTS: One patient could not be tested for reasons unrelated to the device. In the 23 patients who underwent the full protocol, transvenous stimulation activated the diaphragm in 22 of 23 (96%) left phrenic capture attempts and 20 of 23 (87%) right phrenic capture attempts. In one subject, a congenital left-sided superior vena cava precluded right-sided capture. Significant reductions in ventilator pressure-time-product were achieved during stimulation assisted breaths in all 22 paced subjects (range, 9.9-48.6%; p < 0.001). There were no adverse events either immediately or at 2-week follow-up. CONCLUSIONS: In this First-in-Human series, diaphragm pacing with a temporary catheter was safe and effectively contributed to ventilation in conjunction with a mechanical ventilator.
[Mh] Termos MeSH primário: Diafragma/inervação
Terapia por Estimulação Elétrica/métodos
Nervo Frênico
Respiração Artificial/efeitos adversos
Paralisia Respiratória/etiologia
Paralisia Respiratória/cirurgia
[Mh] Termos MeSH secundário: Terapia por Estimulação Elétrica/instrumentação
Seres Humanos
Neuroestimuladores Implantáveis
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170426
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002366


  5 / 1557 MEDLINE  
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[PMID]:28379133
[Au] Autor:Blanco M; Ernst G; Salvado A; Cambursano VH; Borsini E
[Ad] Endereço:Hospital Británico de Buenos Aires, Servicio de Neumonología, CABA.
[Ti] Título:[Non-invasive ventilation in patients with diaphragmatic paralysis. Case report].
[Ti] Título:Utilización de la ventilación no invasiva en pacientes con parálisis diafragmética. Reporte de casos..
[So] Source:Rev Fac Cien Med Univ Nac Cordoba;74(1):55-59, 2017.
[Is] ISSN:1853-0605
[Cp] País de publicação:Argentina
[La] Idioma:spa
[Ab] Resumo:Background Diaphragmatic paralysis (DP) is a rare disease, usually secondary to systemic processes, although idiopathic forms have been described. Aim To describe the use of non-invasive ventilation as a treatment to patients with DP. Material and methods Descriptive study about consecutive cases of DP in a general hospital. Results It has been described 4 patients, all of them with a diminished the maximum mouth pressures and vital capacity in supine position. Three patients presented hypercapnia, and one of them, required intubation with invasive mechanical ventilation. All patients were treated with non-invasive positive pressure (NPPV) mode S/T bilevel, allowing with a reduction in the PCO2, improvement in the symptoms and in the parameters to the nocturnal respiratory polygraphy. Conclusions Use of NPPV in patients with DP could provide a clinical improvement and contributing to recovery of lung functionality that make it recommendable in selected cases.
[Mh] Termos MeSH primário: Ventilação não Invasiva/métodos
Paralisia Respiratória/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170503
[Lr] Data última revisão:
170503
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170406
[St] Status:MEDLINE


  6 / 1557 MEDLINE  
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[PMID]:28249882
[Au] Autor:Ashkir ZM; Tsaknis G
[Ad] Endereço:University Hospitals of Leicester NHS Trust, Leicester, UK.
[Ti] Título:A rash and a rare cause of unilateral diaphragmatic paralysis.
[So] Source:BMJ Case Rep;2017, 2017 Mar 01.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:A 61-year-old man who was an ex-heavy smoker presented to our ambulatory care centre with a 4-week history of dyspnoea on mild exertion. 2 weeks prior to his symptoms, he had developed right-sided cervical herpes zoster for which he was prescribed oral acyclovir by his general practitioner. On examination, a rash over the right C4-5 dermatomes was noted and dullness on percussion of the right mid and lower zones with markedly reduced air entry. His chest radiograph showed a raised right hemi-diaphragm with associated right middle and lower lobe collapse. Further investigation with CT and bronchoscopy did not identify a cause and showed no evidence of underlying malignancy or endobronchial obstruction. An ultrasound 'sniff test' was performed to confirm diaphragmatic paralysis. We present a rare case of cervical herpes-induced diaphragmatic paralysis, and summarise our approach and the current understanding of this interesting condition.
[Mh] Termos MeSH primário: Diafragma/fisiologia
Exantema/etiologia
Herpes Zoster/tratamento farmacológico
Paralisia Respiratória/diagnóstico
[Mh] Termos MeSH secundário: Aciclovir/administração & dosagem
Amitriptilina/administração & dosagem
Herpes Zoster/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Neuralgia/tratamento farmacológico
Paralisia Respiratória/etiologia
Paralisia Respiratória/virologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
1806D8D52K (Amitriptyline); X4HES1O11F (Acyclovir)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170314
[Lr] Data última revisão:
170314
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE


  7 / 1557 MEDLINE  
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[PMID]:28246415
[Au] Autor:Raillard M; Murison PJ; Doran IP
[Ad] Endereço:School of Clinical Veterinary Science, University of Bristol, Langford, North Somerset, England.
[Ti] Título:Suspected bilateral phrenic nerve damage following a mediastinal mass removal in a 17-week-old pug.
[So] Source:Can Vet J;58(3):270-274, 2017 Mar.
[Is] ISSN:0008-5286
[Cp] País de publicação:Canada
[La] Idioma:eng
[Ab] Resumo:The anesthetic management of a pediatric pug for removal of a mediastinal mass is described. During recovery from anesthesia, the dog's respiratory pattern was compatible with bilateral diaphragmatic paralysis. Incidence, complications, possible treatments of phrenic nerve injury, problems of long-term mechanical ventilation, and alternative case management are discussed.
[Mh] Termos MeSH primário: Doenças do Cão/cirurgia
Neoplasias do Mediastino/veterinária
Nervo Frênico/lesões
Complicações Pós-Operatórias/veterinária
[Mh] Termos MeSH secundário: Anestesia/veterinária
Animais
Cães
Neoplasias do Mediastino/cirurgia
Respiração Artificial/veterinária
Paralisia Respiratória/etiologia
Paralisia Respiratória/veterinária
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE


  8 / 1557 MEDLINE  
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[PMID]:28222644
[Au] Autor:Chen H; Yang YL; Xu M; Shi ZH; He X; Sun XM; Luo XY; Chen GQ; Zhou JX
[Ad] Endereço:1 Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
[Ti] Título:Use of the injection test to indicate the oesophageal balloon position in patients without spontaneous breathing: a clinical feasibility study.
[So] Source:J Int Med Res;45(1):320-331, 2017 Feb.
[Is] ISSN:1473-2300
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective To investigate the clinical feasibility of the injection test for balloon placement during oesophageal pressure measurement in patients without spontaneous breathing. Methods The injection test was performed in 12 mechanically ventilated patients under deep sedation and paralysis. During withdrawal of the balloon from the stomach and air injection into the gastric lumen of the catheter, the presence of the injection test wave in the balloon pressure tracing indicated that the whole balloon was positioned above the lower oesophageal sphincter (LES). The positive pressure occlusion test was performed at different balloon positions. Results In each patient, the injection test wave appeared at a distinct balloon depth, with a mean ± standard deviation of 41.9 ± 3.3 cm and range from 37 cm to 47 cm. The optimal ratio of changes in the balloon and airway pressure (0.8-1.2) during the positive pressure occlusion test was obtained when the balloon was located 5 cm and 10 cm above the LES in nine (75%) and three (25%) patients, respectively. Conclusions The injection test is feasible for identification of the whole balloon position above the LES during passive ventilation. The middle third of the oesophagus might be the optimal balloon position.
[Mh] Termos MeSH primário: Balão Gástrico
Intubação Gastrointestinal/métodos
Intubação Intratraqueal/métodos
Respiração com Pressão Positiva/instrumentação
Paralisia Respiratória/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestesia Geral
Esfíncter Esofágico Inferior
Feminino
Seres Humanos
Intubação Gastrointestinal/instrumentação
Intubação Intratraqueal/instrumentação
Masculino
Meia-Idade
Respiração com Pressão Positiva/métodos
Pressão
Estudos Prospectivos
Paralisia Respiratória/fisiopatologia
Estômago
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1705
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1177/0300060516679776


  9 / 1557 MEDLINE  
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[PMID]:28164268
[Au] Autor:Kim BG; Han JU; Song JH; Yang C; Lee BW; Baek JS
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, School of Medicine, Inha University, Incheon, South Korea.
[Ti] Título:A comparison of ultrasound-guided interscalene and supraclavicular blocks for post-operative analgesia after shoulder surgery.
[So] Source:Acta Anaesthesiol Scand;61(4):427-435, 2017 Apr.
[Is] ISSN:1399-6576
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In contrast to interscalene block, there was little information regarding the analgesic efficacy of supraclavicular block for shoulder surgery. This study aimed to compare the analgesic efficacy and side effects of interscalene and supraclavicular blocks for shoulder surgery. METHODS: Patients scheduled for shoulder surgery were assigned to receive either ultrasound-guided interscalene (n = 25) or supraclavicular block (n = 24) with 20 ml of 0.375% ropivacaine. We assessed the duration of post-operative analgesia as a primary outcome and pain scores, supplemental analgesia, diaphragmatic excursion, motor block, fingertip numbness, side effects, and patient satisfaction as secondary outcomes. RESULTS: The duration of post-operative analgesia was not statistically different between groups: 868 (800-1440) min for supraclavicular block vs. 800 (731-922) min for interscalene block (median difference -85 min, 95% CI, -283 to 3 min, P = 0.095). The incidence of diaphragmatic paresis was significantly lower in the supraclavicular block group compared with that in the interscalene block group, both at 30 min after the block (66.7% vs. 92%, P = 0.021) and in the post-anaesthesia care unit (62.5% vs. 92%, P = 0.024). Motor block was higher in the supraclavicular block group in the post-anaesthesia care unit, however, not at 24 h. Other secondary outcomes were similar for both groups. CONCLUSIONS: This study showed no statistically significant difference in the duration of post-operative analgesia between the supraclavicular and interscalene blocks. However, the supraclavicular block was associated with a lower incidence of diaphragmatic paresis compared with that of the interscalene block after shoulder surgery.
[Mh] Termos MeSH primário: Bloqueio Nervoso/métodos
Dor Pós-Operatória/tratamento farmacológico
Ombro/diagnóstico por imagem
Ombro/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Amidas
Anestésicos Locais
Plexo Braquial/diagnóstico por imagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Bloqueio Nervoso/efeitos adversos
Medição da Dor/efeitos dos fármacos
Satisfação do Paciente
Paralisia Respiratória/induzido quimicamente
Paralisia Respiratória/epidemiologia
Resultado do Tratamento
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170314
[Lr] Data última revisão:
170314
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170207
[St] Status:MEDLINE
[do] DOI:10.1111/aas.12864


  10 / 1557 MEDLINE  
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[PMID]:28079615
[Au] Autor:Alter A; Aboussouan LS; Mireles-Cabodevila E
[Ad] Endereço:Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA.
[Ti] Título:Neuromuscular weakness in chronic obstructive pulmonary disease: chest wall, diaphragm, and peripheral muscle contributions.
[So] Source:Curr Opin Pulm Med;23(2):129-138, 2017 Mar.
[Is] ISSN:1531-6971
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: Chronic obstructive lung disease affects the lung parenchyma and airways leading to well described effects in respiratory function. This review describes the current knowledge and advances regarding neuromuscular function and chest wall mechanics, which are affected in chronic obstructive pulmonary disease (COPD). RECENT FINDINGS: In COPD, progressive lung hyperinflation becomes constrained by a chest wall with decreasing capacity to expand, resulting in respiratory muscle inefficiency. There is evidence of neuromuscular uncoupling, that is, the respiratory muscle is unable to increase its output in proportion to increasing neural signals. COPD patients also have evidence of altered peripheral muscles function. The end effect of all these pathological changes is neuromuscular weakness. SUMMARY: Respiratory and peripheral muscles dysfunction is found in patients with COPD. This manifests clinically as dyspnea, poor exercise capacity, and decreased quality of life. We have clear evidence that rehabilitation helps several aspects of patients with COPD. Further understanding of the physiopathology is needed to improve our therapeutic and rehabilitation strategies.
[Mh] Termos MeSH primário: Diafragma/fisiopatologia
Doenças Neuromusculares/fisiopatologia
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Parede Torácica/fisiopatologia
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Dispneia/fisiopatologia
Seres Humanos
Pulmão/fisiopatologia
Debilidade Muscular/fisiopatologia
Doenças Neuromusculares/complicações
Doenças Neuromusculares/reabilitação
Doença Pulmonar Obstrutiva Crônica/complicações
Doença Pulmonar Obstrutiva Crônica/reabilitação
Qualidade de Vida
Respiração
Músculos Respiratórios/fisiopatologia
Paralisia Respiratória/complicações
Paralisia Respiratória/fisiopatologia
Paralisia Respiratória/reabilitação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE
[do] DOI:10.1097/MCP.0000000000000360



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde