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Cited by 221Respiratory Support and MechanismsCardiovascular and exercise physiologyMuscle Physiology and Disorders

The DOI matches its Crossref record; 72 of the 72 references it cites were found in a registry or an index.

Respiratory Muscle Failure

Rochester, Dudley F., Arora, Narinder S.·1983·Medical Clinics of North America
DOI 10.1016/s0025-7125(16)31190-7
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Abstract

The diseases which are commonly complicated by hypercapnic respiratory failure also compromise the respiratory muscles in several ways. Increased work of breathing, mechanical disadvantage, neuromuscular disease, impaired nutritional status, shock, hypoxemia, acidosis, and deficiency of potassium, magnesium, and inorganic phosphorus are the major non-neurologic factors which contribute to respiratory muscle fatigue and failure. Respiratory muscle fatigue has two components. High frequency fatigue occurs rapidly with intense contractile efforts but is usually not severe. It also recovers rapidly with rest. Low frequency fatigue develops more slowly but is severe and requires hours for recovery. Since the spontaneous rate of neural stimulation is predominantly in the low frequency range, this component of fatigue is of particular clinical importance. Fatigue of the inspiratory muscles leads to acute respiratory acidosis, but before carbon dioxide retention occurs, it can be recognized from characteristic symptoms and signs. These include dyspnea which responds to mechanical ventilation, rapid shallow breathing, and asynchronous movements of the chest and abdomen. Inspiratory muscle fatigue must be treated by putting these muscles to rest, by mechanically supporting ventilation. In addition, underlying metabolic nutritional and circulatory abnormalities must be corrected and infection treated. Aminophylline and isoproterenol can restore inspiratory muscle contractility, but controlled clinical trials remain to be done regarding their application in acute and chronic respiratory failure. Inspiratory muscle training improves strength and endurance in patients with obstructive lung disease, cystic fibrosis, and spinal cord injury, but does not always improve physical exercise performance. Again, more work is needed to develop the indications for inspiratory muscle training and to determine the optimum type and duration of the training regimen.

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Crossref · 10.1016/s0025-7125(16)31190-7

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72 of 72 references verified0 citation errors · 0 not checkable

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Citations

Cites

Show all 72 references

Research works printed but not linked: 13

  1. Arora, 1979, Respiratory muscle function in obesity and obesity hypoventilation syndrome, Clin. Res, 27, 394A
  2. Arora, 1981, Effect of chronic obstructive pulmonary disease on diaphragm muscle dimensions (abstract), Am. Rev. Respir. Dis, 123, 176
  3. Arora, 1981, Effect of hypoxia and resistive work on diaphragm muscle ATP and glycogen concentrations in the dog (abstract), Clin. Res, 29, 443A
  4. Arora, 1982, Effect of respiratory acidosis and resistive work on diaphragm phosphagen and glycogen concentration in the dog (abstract), Clin. Res, 30, 425A
  5. Arora, 1982, Effect of chronic obstructive pulmonary disease on sternocleidomastoid muscle (abstract), Am. Rev. Respir. Dis, I25, 252
  6. Arora, 1978, Respiratory muscle and ventilatory function in spinal cord injury, Clin. Res, 26, 443A
  7. Bellemare, 1982, Limitation of diaphragmatic blood flow in dogs, Fed. Proc, 41, 1255
  8. Braun, N. M. Arora, N. S., and Rochester, D. F.: Respiratory muscle and pulnlonary function in proximal myopathies. Thorax, in press.
  9. Grassino, 1981, Diaphragmatic fatigue in chronic obstructive pulmonary disease (abstract), Chest, 80, 373
  10. Hamilton, 1970, Late onset of respiratory insuffi ciency after poliomyelitis, Ann. Physical Med, 10, 223
  11. Marino, 1982, Reversal of the clinical sequelae of respiratory muscle fatigue by intermittent mechanical ventilation, Am. Rev. Respir. Dis, I25, 85
  12. Rochester, 1978, The respiratorv muscles, Basics of RD, 6, 1
  13. Rochester, 1979, Respiratory muscle strength in chronic obstructive lung disease, Am. Rev. Respir. Dis, 119, 151

Cited by

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Metadata

Authors
Rochester, D. F., & Arora, N. S.
Affiliations
  • University of Virginia Medical Center (US)
  • University of Virginia (US)
Corresponding author
Rochester, Dudley F.
Venue
Medical Clinics of North America
Publisher
Elsevier BV
Published
1983-05
Volume
67
Issue
3
Pages
573-597
ISSN
0025-7125 (ISSN-L)
DOI
10.1016/s0025-7125(16)31190-7
OpenAlex
W84772575
Cited by
221
References
72
Citations by year
2026: 2 · 2025: 1 · 2023: 2 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 3 · 2016: 2 · 2015: 2 · 2014: 4 · 2013: 6 · 2012: 2
FWCI
8.51
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Medical Clinics of North America (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
Keywords
respiratory muscle failure, respiratory muscle fatigue, hypercapnic respiratory failure, inspiratory muscle fatigue, low-frequency fatigue, high-frequency fatigue, respiratory acidosis, mechanical ventilation, aminophylline, isoproterenol, inspiratory muscle training, neuromuscular disorders, cystic fibrosis, spinal cord injury, obstructive lung disease
MeSH terms
Airway Obstruction, Animals, Diaphragm, Electromyography, Humans, Intercostal Muscles, Muscle Contraction, Muscle Hypotonia, Muscular Diseases, Neuromuscular Diseases, Pulmonary Fibrosis, Respiratory Function Tests, Respiratory Insufficiency, Thoracic Diseases, Work of Breathing

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