Surgery and the respiratory muscles
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This paper reviews surgery that impairs the function of the respiratory muscles—namely cardiac, thoracic, and upper abdominal surgery, and possible pathophysiological mechanisms are reviewed.Abstract:
Respiratory muscles are the only skeletal muscles vital to life. Surgical procedures can affect the respiratory muscles by a number of pathophysiological mechanisms including thoracoabdominal mechanics, reflexes, neuromechanical coupling, and loss of muscular integrity. Impairment of respiratory muscle function after surgery may lead to postoperative complications such as hypoventilation, hypoxia, atelectasis, and infections, some of which may be life threatening. In this paper we review surgery that impairs the function of the respiratory muscles—namely cardiac, thoracic, and upper abdominal surgery. Therapeutic interventions or protective measures for respiratory muscles during or after each type of surgery are also briefly addressed. Lung transplantation and lung volume reduction surgery are discussed, since both have been shown to improve the function of respiratory muscles, and possible pathophysiological mechanisms are reviewed. The preoperative assessment of respiratory muscle function is also considered. Furthermore, when postoperative pulmonary complications occur it is worth considering whether the cause could be dysfunction of the respiratory muscles and thus a proper assessment of their function is needed.
The most important function of the respiratory muscles is breathing since they are the motor arm of the respiratory system. Breathing, a lifelong task, is borne mainly by the inspiratory muscles, especially the diaphragm. The other inspiratory muscles contribute little to quiet breathing but are recruited when higher levels of ventilation are required, such as in exercise and obstructive or restrictive lung disease. The expiratory muscles are not usually used during breathing except at high levels of ventilatory effort. A second function of the respiratory muscles is to perform explosive manoeuvres such as coughing and vomiting. The respiratory muscles also have a role as stabilisers of the thorax and abdomen since they take part in the formation of the thoracic and abdominal walls. Respiratory muscle function depends on the function of the respiratory centres, …read more
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Pressões respiratórias estáticas máximas
TL;DR: O instrumento clássico para medir ao nível da boca as pressões respiratórias estáticas máximas – pressão inspiratória máXima (PImáx) e pressão expiratórie má Ximas (PEmáX) – é um tubo cilíndrico rígido.
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References
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Textbook of Respiratory Medicine
John Murray,Jay A. Nadel +1 more
TL;DR: This book presents a clinical reference of respiratory medicine that details basic science aspects of pulmonary physiology and describes recently developed, sophisticated diagnostic tools and therapeutic methods.
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Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease
Joel D. Cooper,Elbert P. Trulock,Anastasios N. Triantafillou,G.A. Patterson,Mary S. Pohl,P.A. Deloney,R. S. Sundaresan,Charles L. Roper +7 more
TL;DR: Surgical bilateral lung volume reduction may be of significant value for selected patients with severe chronic obstructive pulmonary disease and marked relief of dyspnea and improvement in exercise tolerance and quality of life.
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Effects of Anesthesia and Paralysis on Diaphragmatic Mechanics in Man
Alison B. Froese,A.C. Bryan +1 more
TL;DR: Using a radiologic technique, the position and pattern of movement of the diaphragm have been evaluated in three adult volunteers, both awake and anesthetized, during spontaneous ventilation and with muscle paralysis and mechanical ventilation.
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Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease.
TL;DR: It is concluded that endurance training can reduce exercise-induced lactic acidosis and improve skeletal muscle oxidative capacity in patients with moderate to severe chronic obstructive pulmonary disease (COPD).
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Improvement in pulmonary function and elastic recoil after lung-reduction surgery for diffuse emphysema
Frank C. Sciurba,Robert M. Rogers,Robert J. Keenan,William A. Slivka,John Gorcsan,Peter F. Ferson,J. M. Holbert,Manuel L. Brown,Rodney J. Landreneau +8 more
TL;DR: Lung-reduction surgery can produce increases in the elastic recoil of the lung in patients with diffuse emphysema, leading to short-term improvement in dyspnea and exercise tolerance.
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