RESPIRATORY MUSCLE STRENGTH DURING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS (CAPD)

Citation
Nm. Siafakas et al., RESPIRATORY MUSCLE STRENGTH DURING CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS (CAPD), The European respiratory journal, 8(1), 1995, pp. 109-113
Citations number
18
Categorie Soggetti
Respiratory System
ISSN journal
09031936
Volume
8
Issue
1
Year of publication
1995
Pages
109 - 113
Database
ISI
SICI code
0903-1936(1995)8:1<109:RMSDCA>2.0.ZU;2-0
Abstract
The purpose of this study was to investigate the effect of chronic ren al failure (CRF) and continuous ambulatory peritoneal dialysis (CAPD) on respiratory muscle function. Global respiratory muscle strength was assessed by measuring mouth pressures during maximum static inspirati on (PImax) near residual volume (RV) and expiration (PEmax) near total lung capacity (TLC), in 26 patients. Maximum pressures, spirometry an d lung volumes were measured before dialysis, 4 h after the administra tion of 2 l of dialysate into the peritoneal cavity, and just after th e next drainage. In addition, biochemical indices (urea, creatinine, s odium, potassium, calcium and phosphorus) and haematological indices ( haemoglobin (Hb) and haematocrit (Hct)) were measured once before the treatment. The results showed that mean PImax and PEmax were normal, w ith a very wide range between patients, before CAPD. However, seven pa tients (27%) showed a PImax of <75% predicted (pred) and eight (31%) a PEmax <75% pred. Maximal pressures decreased significantly during CAP D and increased again after the drainage of fluid. Similarly, lung vol umes were within the normal range before and decreased significantly d uring CAPD. The forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC) ratio did not change. We conclude that respirat ory muscle strength was preserved in the majority of the patients with chronic renal failure treated with CAPD. During CAPD, lung volumes an d respiratory muscle function were decreased, demonstrating an effect of the abdominal cavity on the mechanics of the respiratory system. Ho wever, the decrease in the maximum pressures was less that 20%, indica ting that CAPD is a safe procedure in patients without pre-existing pu lmonary disease or uraemic pulmonary complications. Respiratory muscle strength increased immediately after the drainage of fluid.