Details

Autor(en) / Beteiligte

• Scano, Giorgio
• Goti, Patrizio
• Duranti, Roberto
• Misuri, Gianni
• Emmi, Lorenzo
• Rosi, Elisabetta

Titel

Control of Breathing in a Subset of Patients With Systemic Lupus Erythematosus

Ist Teil von

• Chest, 1995-09, Vol.108 (3), p.759-766

Ort / Verlag

Northbrook, IL: Elsevier Inc

Erscheinungsjahr

1995

Quelle

MEDLINE

Beschreibungen/Notizen

• Inspiratory muscle weakness and abnormalities in breathing pattern and in respiratory drive have been reported in patients with multisystem disorders. In patients with systemic lupus erythematosus (SLE), data on respiratory muscle strength and control of breathing are scarce. We studied a subset of nine female patients with SLE with no major findings of cardiovascular, renal, or neurologic involvement, and with a normal routine chest radiograph. An age- and sex-matched normal group was also studied as a control. We evaluated lung volumes, diffusing lung properties (TLco, TLCO/VA), maximal inspiratory (MIP) and expiratory (MEP) pressures, end-tidal carbon dioxide tension (Pco2), and breathing pattern: ventilation (VE), tidal volume (VT), inspiratory time (TI), and respiratory frequency (Rf). Neural respiratory drive, assessed in terms of mean inspiratory flow (VT/TI), mouth occlusion pressure (P0.1), and surface electromyographic activity of the diaphragm (Edi) and intercostal (Eps) muscles was also evaluated. As a whole, patients exhibited mild decrease in MIP; vital capacity was slightly reduced in two patients and TLCO/VA was moderately reduced in three. During a hypercapnic rebreathing test, ΔVT/ΔPCO2 was lower, ΔP0.1/ΔPCO2 was normal, while ΔEdi/ΔPCO2 and ΔEps/ΔPCO2 were higher in patients compared with normal control subjects. ΔVT/ΔPCO2 significantly related to MIP. At 60 mm Hg of PCO2 patients maintained the rapid and shallow pattern of breathing (RSB) exhibited during room-air breathing: lower VT, shorter Ti, and greater Rf, with VE, VT/TI, and Edi being greater compared with the normal control subjects. These data seem to indicate that in this SLE subset, mild decrease in respiratory muscle strength may accompany an increased respiratory drive, and contribute to a qualitatively abnormal ventilatory response (RSB) to carbon dioxide stimulation.