Evaluación de los músculos respiratorios en la parálisis diafragmática bilateral

Abstract

Assessment of respiratory muscle strength in bilateral diaphragmatic paralysis Measurement of respiratory muscle strength is useful in order to

Comprehensive Assessment of Respiratory Function, a Step towards Early Weaning from the Ventilator

“…Supinkski et al concluded that, in response to phrenic nerve stimulation (PdiTw), Pdi predicts extubation duration better than maximum inspiratory pressure (Pimax), which also anticipates successful extubation with a value of -30 cmH PdiTw estimates respiratory muscle strength, evaluating electromyographic signals and conduction velocity in each hemidiaphragm; its range of normality is 8.8-33 cm H 2 O, but, having such a wide range, it would only be useful to identify severe muscle weakness [42]. It requires highly trained personnel because of its harmful results in terms of pain caused by electrical cervical stimulation, as it can overestimate muscular strength [42], as well as because it can be difficult to locate the phrenic nerve [38,43].…”

“…It is avoided to use it without additional tests due to the effort of using it alone [32] Transdiaphragmatic pressure Allows to understand the injuries, the patient-ventilator interaction, VW failure and muscle work in MV [39] It requires highly trained personnel It's difficult to locate the phrenic nerve [42] Esophageal pressure (Pes)…”

“…Boussuges et al evaluated 210 people with normal spirometric values [53,55]; average excursions were measured at 1.8 ± 0.3 cm on the right side and 1.8 ± 0.4 cm on the left [55]. This method assesses internal anatomy, diaphragmatic thickness (as a sign of atrophy), shortening fraction and diaphragmatic mobility (as a sign of diaphragmatic activity) [42]. García-Sánchez et al made a meta-analysis acquiring diaphragmatic excursion values to predict weaning failure of between 7 mm and 27 mm [56].…”