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Dyspnea and respiratory muscle strength in end-stage liver disease

World Journal of Hepatology 2013年第2期5卷 56-63页

作者： georgios kaltsakas Efstathios Antoniou Anastasios F Palamidas Sofia-Antiopi Gennimata Panorea Paraskeva Anastasios Smyrnis Antonia Koutsoukou Joseph Milic-Emili Nickolaos G Koulouris Respiratory Function Lab 1st Respiratory Medicine Department"Sotiria" Hospital for Diseases of the ChestUniversity of Athens11527 AthensGreece 2nd Propaedeutic Surgery Department "Laiko" HospitalUniversity of Athens11526 AthensGreece Meakins-Christie Labs McGill UniversityMontreal QC H3A 0G4Canada

AIM:To investigate the prevalence of chronic dyspnea and its relationship to respiratory muscle function in end-stage liver ***:Sixty-eight consecutive,ambulatory,Caucasian patients with end-stage liver disease,candidates for liver transplantation,were referred for preoperative respiratory function *** of these(29 men) were included in this preliminary study after applying strict inclusion and exclusion *** of 40 patients(42%) had ascites,but none of them was *** of 40 patients(38%)had a history of hepatic encephalopathy,though none of them was symptomatic at study *** patients with a known history and/or presence of co-morbidities were *** dyspnea was rated according to the modified medical research council(mMRC) 6-point *** disease severity was assessed according to the Model for end-stage liver disease(MELD).Routine lung function tests,maximum static expiratory(Pemax) and inspiratory(Pimax) mouth pressures were *** muscle strength(RMS) was calculated from Pimax and Pemax *** addition,arterial blood gases and pattern of breathing(VE:minute ventilation;VT:tidal volume;VT/TI:mean inspiratory flow;TI:duration of inspiration) were ***:Thirty-five(88%) of 40 patients aged(mean ± SD) 52 ± 10 years reported various degrees of chronic dyspnea(mMRC),ranging from 0 to 4,with a mean value of 2.0 ± *** score was 14 ± ***,percent of predicted(%pred) was 105 ± 35,Pimax,%pred was 90 ± 29,and RMS,%pred was 97 ± *** pressures were below the normal limits in 12(30%),15(38%),and 14(35%) patients,***,comparing the subgroups of ascites to non-ascites patients,all respiratory muscle indices measured were found significantly decreased in ascites *** with ascites also had a significantly worse MELD score compared to non-ascites ones(P = 0.006).Significant correlations were found between chronic dyspnea and respiratory muscle

关键词： Liver transplantation Lung function testing Maximum static mouth pressures Pattern of breathing Respiratory muscle strength

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