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Department of
Pulmonary Diseases, University Hospital Nijmegen, 6500 HB Nijmegen, The
Netherlands
Correspondence to: Dr P N R Dekhuijzen email: R.Dekhuijzen@long.azn.nl
Received 17 December 1999; Accepted for publication 12 April 2000
| The first 150 words of the full text of this article appear below. |
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Respiratory muscle dysfunction in chronic obstructive pulmonary disease (COPD) |
|---|
Dysfunction of the respiratory muscles, especially the diaphragm,
is known to occur in patients with severe chronic obstructive pulmonary
disease (COPD).1-3 Weakness of the diaphragm is part of a
generalised process involving all (respiratory and peripheral) skeletal
muscles. Causative factors for respiratory muscle dysfunction in COPD
include disturbances in electrolytes,4
hypercapnia,5 forward failure,6 and prolonged
use of oral corticosteroids.7 In addition, the altered
geometry of the thorax in severe emphysema compromises the
ventilatory pump function of the diaphragm.8 Malnutrition,
which frequently occurs in moderate to severe COPD,9 could
also play a part in respiratory muscle dysfunction. Recent studies have
indicated that wasting of fat free mass in COPD is associated with
peripheral skeletal muscle weakness.10 However, few data
are available regarding the effects of malnutrition on respiratory
muscle strength. Maximal inspiratory pressure (PImax) in
nutritionally depleted patients with COPD (forced expiratory volume in
one second (FEV1) 45.5 (15.1)%
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