• Am. J. Respir. Crit. Care Med. · Jan 1996

    Comparative Study

    Nocturnal saturation improves by target-flow inspiratory muscle training in patients with COPD.

    • Y F Heijdra, P N Dekhuijzen, C L van Herwaarden, and H T Folgering.
    • Department of Pulmonary Diseases, University of Nÿmegen, Medical Centre Dekkerswald, Groesbeek, The Netherlands.
    • Am. J. Respir. Crit. Care Med. 1996 Jan 1; 153 (1): 260-5.

    AbstractNocturnal desaturations during rapid eye movement (REM) sleep, caused by nonobstructive hypoventilation, occur frequently in patients with chronic obstructive pulmonary disease (COPD). This is partly caused by decreased activity of the intercostal and accessory muscles due to a lower motor command. The diaphragm has to compensate for the diminished activity of these muscles during REM sleep. However, in patients with COPD strength and endurance of the diaphragm may be affected by its unfavorable position on the length-tension curve because of hyperinflation. The aim of this study was to establish the causal relationship between respiratory muscle function and nocturnal saturation in patients with COPD. We hypothesized that target-flow inspiratory muscle training (TF-IMT) would improve nocturnal saturation. In 20 patients with stable COPD (FEV1 35.5 +/- 14.1% of predicted) and a mean nocturnal saturation below 92% we measured maximal inspiratory pressure (PImax), transdiaphragmatic pressure (Pdi), maximal sustainable inspiratory pressure (SIPmax), endurance time, and nocturnal saturation in Weeks 0, 4, and 10. During these 10 wk 10 patients underwent TF-IMT at 60% of PImax and 10 control patients received sham TF-IMT at 10% of PImax. PImax, Pdi, SIPmax, and the endurance time as well as the nocturnal saturation improved significantly in the 60% training group (by 3.0 +/- 1.5 kPa, 3.4 +/- 1.9 kPa, 1.5 +/- 1.4 kPa, 189 +/- 149 s, and 1.9 +/- 2.2%, respectively), whereas no changes occurred in the sham training group. Also, significant correlations were observed between the changes in Pdi, SIPmax, and endurance time on the one hand and the change in nocturnal saturation on the other. We conclude that TF-IMT improves the nocturnal saturation in patients with severe COPD by increasing respiratory muscle strength and endurance.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…