Respiratory Muscle Failure and Respiratory Failure

IF 2.3 3区 医学 Q2 CRITICAL CARE MEDICINE
D. Rochester
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引用次数: 9

Abstract

It is well known that respiratory muscle weakness causes respiratory failure in neuromuscular disease. More recently, we have come to appreciate that respiratory muscle dysfunction contributes significantly to carbon dioxide retention in most of the disorders that predispose to hypercapnic respiratory failure. This is especially so for obstructive diseases of the upper and lower airways, restrictive diseases of the chest wall, and the many conditions other than neuromuscular disease that impair respiratory muscle contractility. To elucidate the mechanisms by which respiratory muscle failure leads to hypercapnic respiratory failure, we address three issues in this article. The section "Respiratory Muscle Failure" reviews the relationship between muscle weakness and fatigue, as well as the concept of "incipient fatigue." Because it is difficult to distinguish among these conditions in the clinical setting, we use the term "failure" to signify any form of impaired respiratory muscle contractility. The section "Respiratory Muscle Failure and the Pattern of Breathing" summarizes evidence to show that respiratory muscle failure causes rapid, shallow breathing. This occurs even though central neural drive is maintained and there is no overt muscle fatigue. The final section indicates that a reduction in tidal volume is the final common pathway linking respiratory muscle failure to hypercapnic respiratory failure.
呼吸肌肉衰竭和呼吸衰竭
众所周知,在神经肌肉疾病中,呼吸肌无力会导致呼吸衰竭。最近,我们已经认识到,在大多数易导致高碳酸血症性呼吸衰竭的疾病中,呼吸肌功能障碍对二氧化碳潴留有重要作用。对于上、下气道的阻塞性疾病、胸壁的限制性疾病,以及除神经肌肉疾病外的许多损害呼吸肌收缩性的疾病,尤其如此。为了阐明呼吸肌衰竭导致高碳酸血症性呼吸衰竭的机制,我们在本文中解决了三个问题。“呼吸肌肉衰竭”一节回顾了肌肉无力和疲劳之间的关系,以及“早期疲劳”的概念。由于在临床环境中很难区分这些情况,我们使用术语“失败”来表示任何形式的呼吸肌收缩性受损。“呼吸肌衰竭和呼吸模式”一节总结了证据,表明呼吸肌衰竭导致快速、浅呼吸。即使中枢神经驱动保持,没有明显的肌肉疲劳,这种情况也会发生。最后一节指出,潮气量的减少是将呼吸肌衰竭与高碳酸血症性呼吸衰竭联系起来的最后共同途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.10
自引率
0.00%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The journal focuses on new diagnostic and therapeutic procedures, laboratory studies, genetic breakthroughs, pathology, clinical features and management as related to such areas as asthma and other lung diseases, critical care management, cystic fibrosis, lung and heart transplantation, pulmonary pathogens, and pleural disease as well as many other related disorders.The journal focuses on new diagnostic and therapeutic procedures, laboratory studies, genetic breakthroughs, pathology, clinical features and management as related to such areas as asthma and other lung diseases, critical care management, cystic fibrosis, lung and heart transplantation, pulmonary pathogens, and pleural disease as well as many other related disorders.
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