全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...

Respiratory Mechanics, Respiratory Muscle Strength, Control of Ventilation and Gas Exchange in Patients with Autoimmune Liver Disease

DOI: 10.4236/ojrd.2024.142003, PP. 25-38

Keywords: Autoimmune Liver Disease, Control of Ventilation, Occlusion Pressure, Passive Relaxation Method, Primary Biliary Cirrhosis, Respiratory Elastance, Respiratory Resistance

Full-Text   Cite this paper   Add to My Lib

Abstract:

Objectives: To assess respiratory elastance and resistive properties in patients with autoimmune liver disorders using the passive relaxation expiration technique and compare findings to a group of patients with non-autoimmune liver disease and control subjects. These findings were then related to control of ventilation and gas exchange. A secondary objective was to assess respiratory muscle strength and gas exchange and their relation to respiratory mechanics. Methods: Measurements included respiratory elastance and resistance using the passive relaxation method. Pulmonary function, gas exchange and control of ventilation were assessed using standard methods. Results: a) Compared to control subjects, Ers in patients with liver disease was on average 50% greater than in controls; b) mean respiratory resistance, expressed as the respiratory constants, K1 and K2 in the Rohrer relationship, Pao/V’ = K1 + K2V’, was not different from control resistance; c) mean maximal inspiratory and maximal expiratory pressures averaged 36% and 55% of their respective control values; d) inspiratory occlusion pressure in 0.1 sec (P0.1) was increased and negatively associated with FVC; and e) increases in P0.1, mean inspiratory flow (Vt/Ti) and presence of respiratory alkalosis confirmed the increase in ventilatory drive. Despite inspiratory muscle weakness in patients, P0.1/Pimax averaged 5-fold higher than in control subjects. Conclusions:

References

[1]  Wallaert, B., Bonniere, P., Prin, L., et al. (1986) Primary Biliary Cirrhosis. Subclinical Inflammatory Alveolitis in Patients with Normal Chest Roentgenograms. Chest, 90, 842-848.
https://doi.org/10.1378/chest.90.6.842
[2]  Spiteri, A., Johnson, M., Epstein, O., et al. (1990) Immunological Features of Lung Lavage Cells from Patients with Primary Biliary Cirrhosis May Reflect Those Seen in Pulmonary Sarcoidosis. Gut, 31, 208-212.
https://doi.org/10.1136/gut.31.2.208
[3]  Uddenfeldt, P., Bjerle, P., Danielsson, Å., et al. (1988) Lung Function Abnormalities in Patients with Primary Biliary Cirrhosis. Acta Medica Scandinavica, 223, 549-555.
https://doi.org/10.1111/j.0954-6820.1988.tb17694.x
[4]  Hourani, J., Bellamy, P., Tashkin, D., et al. (1991) Pulmonary Dysfunction in Advanced Liver Disease: Frequent Occurrence of an Abnormal Diffusion Capacity. The American Journal of Medicine, 90, 693-700.
https://doi.org/10.1016/0002-9343(91)90664-J
[5]  Krowka, M.J., Grambsch, P.M., Edell, E.S., et al. (1991) Primary Biliary Cirrhosis: Relation between Hepatic Function and Pulmonary Function in Patients Who Never Smoked. Hepatology, 13, 1095-1110.
https://doi.org/10.1002/hep.1840130615
[6]  Fallon, M.B. and Abrams, G.A. (2000) Pulmonary Dysfunction in Chronic Liver Disease. Hepatology, 32, 859-865.
https://doi.org/10.1053/jhep.2000.7519
[7]  Duranti, R., Laffi, G., Misuri, G., et al. (1987) Respiratory Mechanics in Patients with Tense Ascites. European Respiratory Journal, 10, 1622-1630.
https://doi.org/10.1183/09031936.97.10071622
[8]  Lindor, K.D., Bowlus, C.L., Boyer, J., et al. (2019) Primary Biliary Cholangitis: 2018 Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology, 69, 394-419.
https://doi.org/10.1002/hep.30145
[9]  Pellegrino, R., Viegi, G., Brusasco, V., et al. (2005) Interpretative Strategies for Lung Function Tests. American Journal of Respiratory and Critical Care Medicine, 26, 948-968.
https://doi.org/10.1183/09031936.05.00035205
[10]  Schoenberg, J.B., Beck, G.J. and Bouhuys, A. (1978) Growth and Decay of Pulmonary Function in Healthy Blacks and Whites. Respiration Physiology, 33, 367-393.
https://doi.org/10.1016/0034-5687(78)90063-4
[11]  Crapo, R.O., Morris, A.H., Clayton, P.D., et al. (1982) Lung Volumes in Healthy Nonsmoking Adults. Bulletin Européen de Physiopathologie Respiratoire, 18, 419-425.
[12]  Knudson, R.J., Kaltenborn, W.T., Knudson, D.E., et al. (1987) The Single-Breath Carbon Monoxide Diffusing Capacity. Reference Equations Derived from a Healthy Nonsmoking Population and Effects of Hematocrit. American Review of Respiratory Disease, 135, 805-811.
https://doi.org/10.1164/arrd.1987.135.4.805
[13]  (2002) ATS/ERS Statement On Respiratory Muscle Testing. American Journal of Respiratory and Critical Care Medicine, 166, 518-624.
https://doi.org/10.1164/rccm.166.4.518
[14]  Black, L.F. and Hyatt, R.E. (1969) Maximal Respiratory Pressures: Normal Values and Relationship to Age and Sex. American Review of Respiratory Disease, 99, 696-702.
[15]  Ringqvist, I. and Ringqvist, T. (1971) Respiratory Mechanics in Untreated Myasthenia Gravis with Special Reference to the Respiratory Forces. Acta Medica Scandinavica, 190, 499-508.
https://doi.org/10.1111/j.0954-6820.1971.tb07466.x
[16]  Whitelaw, W.A., Derenne, J.P. and Milic-Emili, J. (1975) Occlusion Pressure as a Measure of Respiratory Center Output in Conscious Man. Respiration Physiology, 23, 181-99.
https://doi.org/10.1016/0034-5687(75)90059-6
[17]  Milic-Emili, J. (1982) Recent Advances in Clinical Assessment of Control of Breathing. Lung, 160, 1-17.
https://doi.org/10.1007/BF02719267
[18]  Šorli, J., Grassino, A., Lorange, G., et al. (1978) Control of Breathing in Patients with Chronic Obstructive Lung Disease. Clinical Science and Molecular Medicine, 54, 295-304.
https://doi.org/10.1042/cs0540295
[19]  Baydur, A. and Carlson, M. (1994) Respiratory Mechanics by the Passive Relaxation Technique in Conscious Healthy Adults and Patients with Restrictive Respiratory Disorders. Chest, 105, 1171-1178.
https://doi.org/10.1378/chest.105.4.1171
[20]  Dixon, W.J. and Massey, F.J. (1983) Introduction to Statistical Analysis. 4th Edition, McGraw Hill, New York, 385-414.
[21]  Rodriguez-Roisin, R., Pares, A., Bruguera, M., et al. (1981) Pulmonary Involvement in Primary Biliary Cirrhosis. Thorax, 36, 208-212.
https://doi.org/10.1136/thx.36.3.208
[22]  Costa, C., Sambataro, A., Baldi, S., et al. (1995) Primary Biliary Cirrhosis: Lung Involvement. Liver, 15, 196-201.
https://doi.org/10.1111/j.1600-0676.1995.tb00670.x
[23]  Kalashnikov, M., Akulkina, L., Brocko, M., et al. (2023) Interstitial Lung Disease in Primary Biliary Cholangitis: A Cohort Prospective Study. Life (Basel), 13, Article No. 416.
https://doi.org/10.3390/life13020416
[24]  Krowka, M.J., Wiesner, R.H. and Heimbach, J.K. (2013) Pulmonary Contraindications, Indications and MELD Exceptions for Liver Transplantation: A Contemporary View and Look Forward. Journal of Hepatology, 59, 367-374.
https://doi.org/10.1016/j.jhep.2013.03.026
[25]  Heinemann, H.O., Emirgil, C. and Mijnssen, J.P. (1960) Hyperventilation and Arterial Hypoxemia in Cirrhosis of the Liver. The American Journal of Medicine, 28, 239-246.
https://doi.org/10.1016/0002-9343(60)90187-X
[26]  Snell, R.E. and Luchsinger, P.C. (1963) The Relation of Arterial Hypoxemia to the Hyperventilation of Chronic Liver Disease. The American Journal of the Medical Sciences, 245, 289-292.
https://doi.org/10.1097/00000441-196303000-00007
[27]  Kaltsakas, G., Antoniou, E., Palamidas, A.F., et al. (2013) Dyspnea and Respiratory Muscle Strength in End-Stage Liver Disease. World Journal of Hepatology, 5, 56-63.
https://doi.org/10.4254/wjh.v5.i2.56
[28]  Shee, C.D., Ploy-Song-Sang, Y. and Milic-Emili, J. (1985) Decay of Inspiratory Muscle Pressure during Expiration in Conscious Humans. Journal of Applied Physiology, 58, 1859-1865.
https://doi.org/10.1152/jappl.1985.58.6.1859
[29]  Augusto, V.S., Castro, E., Silva, O., Souza, M.E., et al. (2008) Evaluation of the Respiratory Muscle Strength of Cirrhotic Patients: Relationship with Child-Turcotte-Pugh Scoring System. Transplantation Proceedings, 40, 774-776.
https://doi.org/10.1016/j.transproceed.2008.03.002
[30]  Milosevic, M. and Adams, P. (1990) Primary Biliary Cirrhosis and Polymyositis. Journal of Clinical Gastroenterology, 12, 332-335.
https://doi.org/10.1097/00004836-199006000-00022
[31]  Bohan, A. and Peter, J.B. (1975) Polymyositis and Dermatomyositis. The New England Journal of Medicine, 292, 344-347.
https://doi.org/10.1056/NEJM197502132920706
[32]  Lustik, S.J., Chhibber, A.K., Kolano, J.W., et al. (1997) The Hyperventilation of Cirrhosis: Progesterone and Estradiol Effects. Hepatology, 25, 55-58.
https://doi.org/10.1002/hep.510250110
[33]  Contreras, G., Gutiérrez, M., Beroíza, T., et al. (1991) Ventilatory Drive and Respiratory Muscle Function in Pregnancy. American Review of Respiratory Disease, 144, 837-841.
https://doi.org/10.1164/ajrccm/144.4.837
[34]  Passino, C., Giannoni, A., Mannucci, F., et al. (2012) Abnormal Hyperventilation in Patients with Hepatic Cirrhosis: Role of Enhanced Chemosensitivity to Carbon Dioxide. International Journal of Cardiology, 154, 22-26.
https://doi.org/10.1016/j.ijcard.2010.08.066
[35]  Renzi, G., Milic-Emili, J. and Grassino, A.E. (1982) The Pattern of Breathing in Diffuse Lung Fibrosis. Bulletin Européen de Physiopathologie Respiratoire, 18, 461-472.
[36]  Londner, C., Al Dandachi, G., Plantier, L., et al. (2014) Cross-Sectional Assessment of the Relationships between Dyspnea Domains and Lung Function in Diffuse Parenchymal Lung Disease. Respiration, 87, 105-112.
https://doi.org/10.1159/000351110
[37]  Gorini, M., Spinelli, A., Ginanni, R., et al. (1989) Neural Respiratory Drive and Neuromuscular Coupling during CO2 Rebreathing in Patients with Chronic Interstitial Lung Disease. Chest, 96, 824-830.
https://doi.org/10.1378/chest.96.4.824
[38]  Begin, R., Bureau, M.A., Lupien, L., et al. (1982) Pathogenesis of Respiratory Insufficiency in Myotonic Insufficiency: The Mechanical Factors. American Review of Respiratory Disease, 125, 312-318.
[39]  Baydur, A. (1991) Respiratory Muscle Strength and Control of Ventilation in Patients with Neuromuscular Disease. Chest, 99, 330-338.
https://doi.org/10.1378/chest.99.2.330
[40]  Holle, R.H.O., Schoene, R.B. and Pavlin, E.J. (1984) Effect of Respiratory Muscle Weakness on P0.1 Induced by Partial Curarization. Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology, 57, 1150-1157.
https://doi.org/10.1152/jappl.1984.57.4.1150
[41]  Banzett, R. and Mead, J. (1985) Reflex Compensation for Changes in Operational Length of Inspiratory Muscles. The Thorax Part A, Lung Biology in Health and Disease, 29, 595-604.
[42]  Krowka, M.J., Dickson, E.R., Wiesner, R.H., et al. (1992) A Prospective Study of Pulmonary Function and Gas Exchange Following Liver Transplantation. Chest, 102, 1161-1166.
https://doi.org/10.1378/chest.102.4.1161

Full-Text

Contact Us

[email protected]

QQ:3279437679

WhatsApp +8615387084133