Pulmonary Function in Diaphragmatic Paralysis

McCredie, Michael; Lovejoy, Frank W.; Kaltreider, Nolan L.

doi:10.1136/thx.17.3.213

Cited by 55 publications

(17 citation statements)

References 10 publications

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“…Diaphragmatic weakness results in considerable respiratory difficulty which is most marked in the supine position (McCredie et al, 1962). Examination of the patient lying supine reveals paradoxical inward motion of the abdomen during inspiration and the patient's vital capacity, which may initially be low, falls by more than 25% in the supine position.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic myasthenia in mother and child

Mier

Havard

1985

Postgraduate Medical Journal

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Summary:A 28 year old patient with ocular myasthenia for 2y gave birth to a baby with diaphragmatic weakness. Following delivery the mother developed severe weakness of the diaphragm and required assisted ventilation. The baby recovered spontaneously and the mother responded to treatment with plasma exchange and immunosuppression. Neither mother nor baby responded to anticholinergic drugs and in neither serum were acetyl choline receptor antibodies detected.

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Section: Discussionmentioning

confidence: 99%

Diaphragmatic myasthenia in mother and child

Mier

Havard

1985

Postgraduate Medical Journal

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“…A number of lung function studies in patients with unilateral paralysis of the diaphragm have been published [8,11,13]. Regional lung function studies are, however, sparse [7,14], The diaphragm is considered to contri bute up to 60-70% of the total ventilation at rest both in the sitting and supine positions.…”

Section: Introductionmentioning

confidence: 99%

Regional and Total Lung Function Studies in Patients with Hemidiaphragmatic Paralysis

Arborelius

Lilja

Senyk³

1975

Respiration

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Global and regional lung function were studied in 17 subjects with hemidiaphragmatic paralysis. Global lung function (VC, MVV, and FEV1) in the sitting position was reduced by an average of about 25 %. Regional lung function data in the same position showed a considerable decrease in perfusion (19%), ventilation (20%), and lung volume (7%) of the diseased side as compared to reference values obtained in healthy volunteers. Compared to the partition of function in the supine, the perfusion of the affected lung increased when it was lowermost in the lateral decubitus position, while regional FRC decreased and ventilation changed little. When uppermost, perfusion and ventilation of the affected lung decreased while FRC_r·increased somewhat. The arterial oxygen tension was significantly below normal in the supine position but in the normal range in the sitting position. It increased further during exercise. Bronchography showed compression of the basal lung segments on the affected side in the erect, and kinking and obliteration of lower lobe bronchi in the supine position and still more when the lung was lowermost in the lateral decubitus position.

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“…Diaphragmatic dysfunction is most detrimental to respiratory function when the subject is in the supine position. [12][13][14] …”

Section: Discussionmentioning

confidence: 99%

“…Diaphragmatic dysfunction is most detrimental to respiratory function when the subject is in the supine position. [12][13][14] It is probable that the loss of postural influence on intercostal muscle tone, known to occur during sleep,'4 would further compound this effect. There exists, therefore, a potential mechanism whereby this disorder may present as a case of sudden infant death, a syndrome in which familial recurrence is recognised.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic paralysis due to spinal muscular atrophy. An unrecognised cause of respiratory failure in infancy?

McWilliam¹,

Gardner-Medwin²,

Doyle³

et al. 1985

Archives of Disease in Childhood

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SUMMARY An unusual form of spinal muscular atrophy presenting with respiratory failure was observed in four infants from two families. In one, whose death was attributed to pneumonia, the diagnosis was inferred retrospectively after two siblings died from an identical illness and were shown to have diaphragmatic paralysis and the typical electrophysiological and histological features of spinal muscular atrophy. Other signs of skeletal muscular weakness were absent or inconspicuous. The fourth, unrelated infant presented in an identical way but has survived for over a year on a ventilator. Two months after the onset of respiratory paralysis, more extensive skeletal muscular weakness was seen. Other infants, dying of unexplained respiratory illness, may have this disorder and some may be included in the miscellany of disorders that constitute the sudden infant death syndrome.

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Pulmonary Function in Diaphragmatic Paralysis

Cited by 55 publications

References 10 publications

Diaphragmatic myasthenia in mother and child

Diaphragmatic myasthenia in mother and child

Regional and Total Lung Function Studies in Patients with Hemidiaphragmatic Paralysis

Diaphragmatic paralysis due to spinal muscular atrophy. An unrecognised cause of respiratory failure in infancy?

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