Respiratory Muscles in Chronic Obstructive Pulmonary Disease

1. Front Matter

   Pages 3-14

   PDF

2. Aspects of Respiratory Muscles Physiology

   1. Front Matter

      Pages 15-15

      PDF

   2. Some old concepts in respiratory muscle mechanics

      • Jean Philippe Derenne

      Pages 17-21

   3. Inspiratory muscle physiology, with particular regard to the diaphragm

      • P. T. Macklem

      Pages 23-34

   4. Respiratory muscle physiology with particular regard to rib cage muscles

      • M. Estenne

      Pages 35-39

   5. Patterns of inspiratory muscle activation with changing levels of ventilatory demand

      • E. D’Angelo

      Pages 41-48

   6. Chest wall and diaphragmatic afferents: their role during external mechanical loading and respiratory muscle ischemia

      • Y. Jammes

      Pages 49-57

   7. The oxygen cost of respiratory and non-respiratory muscles

      • S. Sanci, S. Romano, S. Field, V. Bellia, G. Bonsignore, A. Grassino

      Pages 59-67

   8. EMG evaluation of respiratory muscles

      • A. Arrigo, R. Casale, M. Buoncuore

      Pages 69-74

3. Aspects of Respiratory Muscles Pathophysiology

   1. Front Matter

      Pages 75-75

      PDF

   2. Pathways leading to skeletal muscle fatigue

      • A. Grassino

      Pages 77-87

   3. Efficientcy of breathing during hyperinflation

      • P. W. Collet, L. A. Engel

      Pages 89-93

   4. Effect of lung volume on in vivo contraction characteristics of the human diaphragm

      • J. Smith, F. Bellemare

      Pages 95-110

   5. Nutritional and metabolic aspects of COPD

      • E. Fiaccadori, S. Del Canale, A. Guariglia

      Pages 111-123

   6. Inspiratory muscles and dyspnea

      • J. W. Fitting

      Pages 125-131

   7. Respiratory muscle weakness

      • M. Green, A. K. Mier, J. Moxham

      Pages 133-139

   8. Intrinsic PEEP and its ramifications in patients with respiratory failure

      • J. Milic-Emili, S. B. Gottfried, A. Rossi

      Pages 141-148

   9. Early Changes in respiratory mechanics in acute respiratory failure

      • A. Rossi, R. Poggi, E. Manzin, C. Broseghini, R. Brandolese

      Pages 149-160

   10. The respiratory muscles in acute respiratory failure

       • R. Pariente

       Pages 161-162

4. Therapeutical Approaches

   1. Front Matter

      Pages 163-163

      PDF

While emphysema and chronic bronchitis are primarily lung di­ seases, one of their major consequences is to deeply affect the function of the respiratory muscles. Lung hyperinflation shortens the inspiratory muscles due to increased airways resistance, more of their effort is demanded and changes in nutritional status wea­ ken them further. Their malfunction can lead to severe dyspnea and to failure of the ventilatory pump. Over the last 10 years we have witnessed an explosion of information of how respiratory muscles function in health and disease, new techniques for their evaluation have been created, the concept of fatigue, weakness, and failure was developed, and their rest or training was attemp­ ted. The implication of respiratory muscles malfunction in respi­ ratory medicine has reached a prominent place. It seems remarkable that while some aspect of skeletal muscles function requires molecular biology techniques to find new an­ swers, we still know little on respiratory muscles interaction, stra­ tegies of coordination, their role in dyspnea, chronic hypercapnia or how to effectively improve their function in patients. This workshop was organized and held at the Medical Center of Rehabilitation in Montescano and represents an attempt to focus on how the newly adquired wealth of information can eventually be trasformed into medical care. The particpants in this workshop brought forward challenging thoughts and we are most grateful for their participation. This book represents a report of the proceedings and also provides the most updated information in this field.

• biology
• breathing
• nutrition
• pathophysiology
• physiology
• skeletal muscle
• sleep

• Meakins-Christie Laboratories, McGill University and Notre-Dame Hospital, University of Montreal, Canada

  A. Grassino

• Medical Centre of Rehabilitation, Montescano, Pavia, Italy

  C. Fracchia, C. Rampulla

• Meakins-Christie Laboratories, McGill University, Montreal, Canada

  L. Zocchi

Policies and ethics