Respiratory function during wakefulness and sleep among survivors of respiratory and non-respiratory poliomyelitis.
The purpose of this study was to determine whether there is a difference in respiratory mechanics and gas exchange between polio survivors and healthy, age-matched controls during wakefulness and sleep. Polio survivors were divided into four groups. The first group included those who had evidence of respiratory muscle involvement originally (PRM) and the second group included those who had bulbar muscle involvement originally (PBM). The third and fourth groups had only limb involvement originally but were separated by absence (PSL) or presence of a scoliosis (PSS) at the time of their evaluation. Each subject completed baseline and one year follow-up measurements of lung volumes, diffusion, flow rates, respiratory muscle strength, central and peripheral chemoreflexes and arterial blood gases. Sleep measurements included a full respiratory polysomnographic study. Fifty polio survivors and 13 controls completed the study. The PRM and PSS groups had an elevated arterial carbon dioxide tension (PaCO2) (mean +/- SE 6.0 +/- 0.4 and 6.0 +/- 0.3 kPa, respectively), reduced vital capacity (2.8 +/- 0.3 and 2.9 +/- 0.3 l, respectively), reduced maximal inspiratory pressure (-5.9 +/- 0.7 and -5.4 +/- 0.8 kPa, respectively) and reduced maximal expiratory pressure (9.8 +/- 1.1 and 9.1 +/- 1.2 kPa, respectively), when compared with non-polio controls. During sleep PRM and PSS groups experienced a higher PaCO2 (6.5 +/- 0.5 and 6.7 +/- 0.4 kPa, respectively) and a lower arterial oxygen saturation (SaO2) (89 +/- 4 and 86 +/- 3%, respectively). There were no differences among groups for diffusion, flow rates and chemoreflexes. All other polio survivors showed essentially normal respiratory function.(ABSTRACT TRUNCATED AT 250 WORDS)
Dolmage
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TE
Dept of Medicine, University of Toronto, West Park Hospital, Canada.
Avendano
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MA
Goldstein
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RS
D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011051:Poliomyelitis / Q000503:physiopathology*; D011052:Poliomyelitis, Bulbar / Q000503:physiopathology*; D016262:Postpoliomyelitis Syndrome / Q000503:physiopathology*; D011659:Pulmonary Gas Exchange / Q000502:physiology*; D015656:Respiratory Mechanics / Q000502:physiology*; D012133:Respiratory Paralysis / Q000503:physiopathology; D012890:Sleep / Q000502:physiology; D014851:Wakefulness / Q000502:physiology