Mechanics of respiratory muscles in single-lung transplant recipients.
BACKGROUND
Emphysema and pulmonary fibrosis force the patients to breathe at an abnormal lung volume, which alters the lengths of the respiratory muscles and thereby their work capability is reduced. After single-lung transplantation, muscle function is restored on the side of the transplant but it may be asymmetric to that on the side of the native diseased lung.


OBJECTIVE
Investigating the hypothesis that single-lung transplantation induces mechanical asymmetry of the respiratory muscles on the two sides.


METHODS
Simultaneously noninvasive measurements of inspiratory and expiratory mouth pressure, airflow rate and electromyography signals from the sternomastoid, external intercostal, rectus abdominis and external oblique muscles were acquired during different breathing maneuvers. The study group included 10 single-lung transplant recipients (5 with pulmonary fibrosis and 5 with emphysema) and 10 healthy controls.


RESULTS
Analysis of the finding shows a significant lower global strength of the respiratory muscles of single-lung transplant recipients compared to that of healthy subjects. No significant difference in the EMG signals of respiratory muscles was found either between the different groups or between the sides of the transplant and the native lung in the patient groups. Both single-lung transplant recipients and healthy subjects demonstrated high EMG activity of the inspiratory muscles during inspiration at different breathing efforts.


CONCLUSIONS
Patients after single-lung transplantation have lower respiratory muscle strength than healthy subjects, but apparently normal electrical activity. The lower global respiratory muscle strength emphasizes the importance of their rehabilitation before and after single-lung transplantation.
Ratnovsky
Anat
A
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel. anatrat@eng.tau.ac.il
Elad
David
D
Izbicki
Gabriel
G
Kramer
Mordechai R
MR
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011656:Pulmonary Emphysema / Q000503:physiopathology / Q000601:surgery; D011658:Pulmonary Fibrosis / Q000503:physiopathology / Q000601:surgery; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics / Q000502:physiology*; D012132:Respiratory Muscles / Q000502:physiology*; D014939:Work of Breathing / Q000502:physiology*