RT Journal Article
SR Electronic
T1 RESPIRATORY MUSCLE STRENGTH DURING AND AFTER HOSPITALIZATION FOR COPD EXACERBATION.
JF Respiratory Care
FD American Association for Respiratory Care
SP respcare.02393
DO 10.4187/respcare.02393
A1 Rafael Mesquita
A1 Leila Donária
A1 Isabel C. H. Genz
A1 Fabio Pitta
A1 Vanessa S. Probst
YR 2013
UL http://rc.rcjournal.com/content/early/2013/05/28/respcare.02393.abstract
AB BACKGROUND: A more profound investigation of the respiratory muscle strength during Chronic Obstructive Pulmonary Disease (COPD) exacerbations needs to be done. We aimed to investigate the strength of the respiratory muscles and its related factors in patients with COPD during and after hospitalization for exacerbation. METHODS: Nineteen patients (12 males, mean age 67 ± 11 years, median forced expiratory volume in the first second [FEV1] 26 [19-32]% predicted) had their lung function, respiratory and quadriceps muscle strength assessed at admission (day 1), discharge and one month after discharge (1mD) for a hospitalization due to disease exacerbation. RESULTS: At admission, 68% of the patients presented inspiratory muscle dysfunction (IMD, Maximal Inspiratory Pressure [PImax]<70% predicted). The inspiratory muscle strength increased from day 1 to 1mD (56 [45564] vs 65 [51574] cmH2O, respectively; P<.05), as well as the expiratory muscle strength from day 1 to both discharge and 1mD (99 [655117] vs 109 [775136] and 114 [905139] cmH2O, respectively; P<.05). The inspiratory capacity (IC) increased from discharge to 1mD (1.59 ± 0.44 vs 1.99 ± 0.54 liters, respectively; P<.05). No significant change was observed in other lung function variables or in quadriceps strength (P>.05 for all). Moreover, at admission the IMD and the reduction in IC (<80% predicted) correlated linearly (rϕ=0.62, P=.03), while the expiratory muscle strength correlated inversely to the FEV1 (Spearman's rho=50.61, P=.005) and the IC (Spearman's rho=50.54, P=.02). CONCLUSIONS: There was a high prevalence of inspiratory muscle dysfunction during hospitalization due to COPD exacerbation. Inspiratory and expiratory muscle strength, however, increased markedly during and after hospitalization. The degree of airflow obstruction and hyperinflation were related to both these variables.