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Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis.

Publication ,  Journal Article
Borel, CO; Tilford, C; Nichols, DG; Hanley, DF; Traystman, RJ
Published in: Chest
February 1991

Diaphragmatic muscle performance during acute ventilatory failure due to Guillain-Barré syndrome and myasthenia gravis was assessed to evaluate (1) diaphragmatic function during weaning from ventilatory support and (2) diaphragmatic tension-time integral (TTdi) during ventilatory failure. We used a multilumen nasogastric tube and a pneumotachograph to measure transdiaphragmatic pressure per breath (Pdi), maximum transdiaphragmatic pressure (Pdimax), tidal volume (VT), and inspiratory time fraction during 74 spontaneous breathing trials in nine patients. Diaphragmatic performance was poor in all patients. The Pdi, Pdimax, and VT improved significantly, but values for Pdi and Pdimax remained low even after weaning. Improvement in Pdimax was the best predictor of recovery (r = 0.48; p less than 0.001). Maximal inspiratory force correlated with Pdimax (r = 0.48; p less than 0.005), but FVC did not. The TTdi rarely exceeded the expected fatigue threshold of 0.15 in spite of the patient's inability to sustain ventilation. Although our patients demonstrated diaphragmatic weakness, TTdi did not demonstrate diaphragmatic fatigue.

Duke Scholars

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

February 1991

Volume

99

Issue

2

Start / End Page

444 / 451

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Tidal Volume
  • Respiratory System
  • Respiratory Insufficiency
  • Respiration
  • Pressure
  • Polyradiculoneuropathy
  • Myasthenia Gravis
  • Middle Aged
  • Male
 

Citation

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Borel, C. O., Tilford, C., Nichols, D. G., Hanley, D. F., & Traystman, R. J. (1991). Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis. Chest, 99(2), 444–451. https://doi.org/10.1378/chest.99.2.444
Borel, C. O., C. Tilford, D. G. Nichols, D. F. Hanley, and R. J. Traystman. “Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis.Chest 99, no. 2 (February 1991): 444–51. https://doi.org/10.1378/chest.99.2.444.
Borel CO, Tilford C, Nichols DG, Hanley DF, Traystman RJ. Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis. Chest. 1991 Feb;99(2):444–51.
Borel, C. O., et al. “Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis.Chest, vol. 99, no. 2, Feb. 1991, pp. 444–51. Pubmed, doi:10.1378/chest.99.2.444.
Borel CO, Tilford C, Nichols DG, Hanley DF, Traystman RJ. Diaphragmatic performance during recovery from acute ventilatory failure in Guillain-Barré syndrome and myasthenia gravis. Chest. 1991 Feb;99(2):444–451.
Journal cover image

Published In

Chest

DOI

ISSN

0012-3692

Publication Date

February 1991

Volume

99

Issue

2

Start / End Page

444 / 451

Location

United States

Related Subject Headings

  • Ventilator Weaning
  • Tidal Volume
  • Respiratory System
  • Respiratory Insufficiency
  • Respiration
  • Pressure
  • Polyradiculoneuropathy
  • Myasthenia Gravis
  • Middle Aged
  • Male