Twitch mouth pressure for detecting respiratory muscle weakness in suspicion of neuromuscular disorder.
Neuromuscul Disord
; 27(6): 518-525, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28318818
Twitch mouth pressure using magnetic stimulation of the phrenic nerves and an automated inspiratory trigger is a noninvasive, non-volitional assessment of diaphragmatic strength. Our aims were to validate this method in patients with suspected neuromuscular disease, to determine the best inspiratory-trigger pressure threshold, and to evaluate whether twitch mouth pressure decreased the overdiagnosis of muscle weakness frequently observed with noninvasive volitional tests. Maximal inspiratory pressure, sniff nasal pressure, and twitch mouth pressure were measured in 112 patients with restrictive disease and suspected neuromuscular disorder. Esophageal and transdiaphragmatic pressures were measured in 64 of these patients to confirm or infirm inspiratory muscle weakness. Magnetic stimulation was triggered by inspiratory pressures of -1 and -5 cmH2O. The -5 cmH2O trigger produced the best correlation between twitch mouth pressure and twitch esophageal pressure (R2 = 0.86; P <0.0001). The best association of noninvasive tests to predict inspiratory muscle weakness was sniff nasal pressure and twitch mouth pressure. Below-normal maximal inspiratory pressure and sniff nasal pressure values suggesting inspiratory muscle weakness were found in 63/112 patients. Only 52 of these 63 patients also had abnormal twitch mouth pressure. In conclusion twitch mouth pressure measurement is a simple, noninvasive, nonvolitional technique which may help to select patients with suspected neuromuscular disorder for invasive inspiratory-muscle investigation.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Testes de Função Respiratória
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Músculos Respiratórios
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Debilidade Muscular
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Doenças Neuromusculares
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neuromuscul Disord
Assunto da revista:
NEUROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Brasil
País de publicação:
Reino Unido