Chest
Clinical InvestigationsMechanism of CO2 Retention in Patients With Neuromuscular Disease
Section snippets
Subjects
Twenty consecutive patients (10 men) with a mean age of 47.6 years (range, 23 to 67 years) were studied: 11 patients with limb-girdle dystrophy (LGD), 3 with Duchenne muscular dystrophy, 2 with amyotrophic lateral sclerosis, 1 with Charcot-Marie-Tooth syndrome, 1 with Becker muscular dystrophy, 1 with MD, 1 with facioscapulohumeral dystrophy, and no respiratory complaints. Nine were ambulatory, and 11 were wheel-chair bound. The standard criteria were used to select patients.20, 21
None of the
Results
Clinical, anthropometric, and respiratory function characteristics of the patients (and control subjects) are shown in Table 1. As shown in Table 1, vital capacity (VC) was reduced in 11 patients, as was total lung capacity in 9. The means of MIP (47.8 ± 28.3 cm H2O; range, 11 to 127 cm H2O; p = 0.00001) and MEP (49.5 ± 26.2 cm H2O; range, 15 to 104 cm H2O; p = 0.00002) were significantly lower than in control subjects. In 11 patients and 10 patients, the values of MIP and MEP, respectively,
Discussion
We have found that in patients with NMD, Eldyn (%Pplsn) is the strongest predictor of the variance in Paco2. Increased Eldyn (%Pplsn) was associated with a decreased Ti, which truncates Vt, thereby leading to chronic CO2 retention (Paco2).
One can argue that this type of study should pertain to patients with more advanced disease. In fact, nine of the patients had Paco2 values < 42 mm Hg, which does not indicate a definite CO2 retention. However, a sustained e at a level required to
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This study was supported by a grant from MPI of Italy.