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  • Title: [Hypodynamic respiratory insufficiency. Diagnostic investigation].
    Author: Wiis J, Mortensen J, Jacobsen E.
    Journal: Ugeskr Laeger; 2002 Dec 30; 165(1):15-20. PubMed ID: 12529942.
    Abstract:
    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.
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