Regional lung function in unilateral diaphragmatic paralysis.

Ridyard, J B; Stewart, R M

doi:10.1136/thx.31.4.438

Cited by 47 publications

(27 citation statements)

References 6 publications

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“…The effect of paralysis of the diaphragm on regional lung function has been studied previously only in patients with unilateral paresis (Arborelius, Lilja & Senyk 1975a,b;Ridyard & Stewart, 1976;Weitzenblum, Moyses, Hirth, Kuissu I % Methlin, 1977). In general, reduction in ventilation, alveolar volume and perfusion was found at the base of the lung overlying the paralysed diaphragm.…”

Section: Discussionmentioning

confidence: 98%

Regional Lung Function in Bilateral Diaphragmatic Paralysis

et al. 1980

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1. The distribution of regional function in the lungs of six patient with bilateral diaphragmatic paralysis was investigated by continuous inhalation and infusion of the radioactive gases 81mKr and 85mKr during tidal breathing. 2. In the supine and right lateral decubitus postures the vertical distribution of ventilation per unit alveolar volume was less in the dependent zones, the reverse of that found in normal subjects. In the upright posture ventilation was slightly decreased at the lung base. Perfusion per unit alveolar volume was more uniformly distributed than normally in the upright posture, and decreased from superior to inferior in the supine posture. In the lateral decubitus posture, perfusion of the lower lung was greater than that of the upper. Ventilation/perfusion ratios were more uniformly distributed in the patients than in normal subjects, except in the right lateral decubitus posture. 3. Alterations in the distribution of ventilation may be explained in terms of the altered mechanical interaction of chest wall, mediastinal and abdominal contents, with selective use of intercostal and accessory muscles. The effects on the distribution of blood flow are probably related to the low end-expiratory lung volume.

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Section: Discussionmentioning

confidence: 98%

Regional Lung Function in Bilateral Diaphragmatic Paralysis

et al. 1980

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“…The clini cal details of our patients are presented in table 1. In 11 patients the pathogenesis was unknown, while in the remaining patient it was iatrogenic.…”

Section: Methodsmentioning

confidence: 99%

“…There are reduc tions in ventilation and perfusion of the lower lobe on the affected side leading to some mismatching and widening of alveolar-arterial oxygen difference and mild hypoxemia. These findings deteriorate in the su pine position [1][2][3]. Arterial oxygen tension is signifi cantly below normal in the supine position but often in the normal range in the sitting position.…”

Section: Introductionmentioning

confidence: 93%

Nocturnal Hypoxia in Unilateral Diaphragmatic Paralysis

Patakas

Tsara²,

Zoglopitis³

et al. 1991

Respiration

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Pulmonary function has been studied extensively in patients with unilateral diaphragmatic paralysis (UDP), but there is scarce information regarding the respiratory function during sleep in this condition. We therefore studied pulmonary function in 12 patients with UDP when awake and when asleep. Diaphragmatic dysfunction was confirmed by the demonstration of low maximal transdiaphragmatic pressures in most of our patients; paradoxical gastric pressure swing was observed in 6 patients. There was a restrictive pattern in pulmonary function tests and resting arterial blood gases were rather well preserved (range SaO₂ 90–95%). Overnight sleep monitoring showed that the time spent in REM sleep and stage 3 and 4 sleep was reduced. The mean maximum decrease in SaO₂ was 15.2 ± 6.2% and the time with an SaO₂ drop of more than 5% of the awake SaO₂ was 25.4 ± 22.8 min. None of our patients was in respiratory failure or had clinical evidence of cor pulmo-nale. We conclude that UDP leads to significant nocturnal hypoxemia but, in the absence of systemic lung disease, does not lead to chronic respiratory failure and cor pulmonale

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“…A diaphragm paralysis due to phrenicotomy causes decreases in tidal volume and in dynamic lung compliance, and an increase in the work of breathing due to paradoxical movements of the paralysed diaphragm [5][6][7], which may lead to increases in postoperative morbidity and motility. Diaphragm plication is an acceptable treatment for paediatric patients with life-threatening unilateral diaphragm paralysis [8][9][10], while benefits have also been reported in adult patients with chronic unilateral diaphragm paralysis [1,11].…”

Section: Discussionmentioning

confidence: 99%