Respiratory monitoring in neuromuscular disease - capnography as an additional tool?

Daytime complaints like fatigue, sleepiness and cognitive dysfunction in ne uromuscular disease can be due to nocturnal hypercapnia and hypoxemia. Dayt ime respiratory diagnostics does not reflect sleep disordered breathing. No cturnal pulse oxymetry and capnography were performed in 11 patients (15-75 years old) with different slowly progressive neuromuscular diseases. Only four patients complained of dyspnea. Pulmonary function was abnormal in thr ee patients. Blood gas samples showed a hypoxemia in three patients. Pulse oxymetry results were pathological in six patients. Nine patients presented abnormal capnographies. According to these results either nocturnal oxygen application was initiated or ventilatory parameters were modified. Daytime symptoms and muscular strength improved markedly. Capnography and pulse ox ymetry should be performed during the course of neuromuscular disease to de tect respiratory insufficiency. Capnography seems to be a more sensitive in dicator for respiratory impairment especially when artificial ventilation h as been initiated. (C) 2001 Elsevier Science B.V. All rights reserved.