Clinical relevance of maximal inspiratory pressure: determination in COPD exacerbation.
Muscle dysfunction represents a pathophysiological feature of chronic obstructive pulmonary disease (COPD). Muscle impairment contributes to decreased effort capacity in these patients at least in the same proportion as pulmonary function limitation. Maximal inspiratory pressure (MIP) is a reliable, noninvasive parameter for assessing the respiratory muscle capacity. The aim of the present study was to determine the role of MIP in effort capacity decrease in COPD patients. MIP was measured in 121 COPD patients without hyperinflation (RV < 150%) together with the following investigations: body plethysmography, body impedance analysis, dynamometry, 6-minute walking test (6MWT), determination of SaO(2) and serum levels of highly sensitive C-reactive protein (hsCRP). MIP (kPa) was significantly decreased in moderate-severe stages (6.19 +/- 2.42, COPD II; 5.35 +/- 2.49, COPD III; 4.56 +/- 1.98, COPD IV vs 7.90 +/- 2.61 in controls, P < 0.001), whereas the muscle force assessed by dynamometry was decreased only in advanced stages of disease (0.47 +/- 0.12, COPD III; 0.41 +/- 0.07, COPD IV vs 0.71 +/- 0.16 in controls, P < 0.001). The values of MIP correlated (r = 0.53, P = 0.0003) with the distance walked in 6MWT. MIP may provide additive information concerning the general profile of muscle dysfunction in COPD patients.
Tudorache
Voicu
V
Department of Pneumology, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania. voicu.tudorache@yahoo.com <voicu.tudorache@yahoo.com>
Oancea
Cristian
C
Mlădinescu
Ovidiu Fira
OF
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D013147:Spirometry / Q000295:instrumentation
D002097:C-Reactive Protein
Eur Respir J. 2006 May;27(5):874-6
16707386
Eur Respir J Suppl. 2003 Nov;46:41s-51s
14621106
Am J Respir Crit Care Med. 2002 Dec 1;166(11):1491-7
12406842
Rev Mal Respir. 2005 Feb;22(1 Pt 2):2S37-46
15968795
N Engl J Med. 2004 Mar 4;350(10):1005-12
14999112
Pneumologia. 2001 Jan-Mar;50(1):33-8
11374378
J Cardiopulm Rehabil. 2000 Nov-Dec;20(6):353-60
11144041
Thorax. 2003 Sep;58(9):752-6
12947130
Am J Respir Crit Care Med. 1999 Apr;159(4 Pt 2):S1-40
10194189