Chest
Original Research: Lung Function TestingLung Function Accurately Predicts Hypercapnia in Patients With Duchenne Muscular Dystrophy
Section snippets
Study Design
Patients who met inclusion criteria for one of the groups on this study were followed up at our center. These patients were included in the present cross-sectional study. Patients were systematically assessed every 6 months during a 24-h scheduled hospital admission.
Patients
During the period from January 1, 1995, until December 31, 2004, 168 DMD patients were referred to Hospital Inkendaal, a specialist center for patients with neuromuscular disease. Study inclusion criteria comprised wheelchair-bound
Results
Table 1reports patient characteristics from group S, group N, and group D. The mean height was similar in the three groups. Despite the older age, VC and Vtwere progressively lower in the three groups (p < 0.001). The patients breathed shallower and more rapidly in group N compared to group S (p < 0.05), but this pattern was not different from group D. The VC, Vt, MIP, Vt/VC ratio, Ve, and BMI but not RR and RSBI were significantly lower in group D compared to group N. Finally, the Veat rest
Discussion
The present study suggests that patients with DMD remain normocapnic as long as VC remains > 1,820 mL. If VC drops below this value, nocturnal hypercapnia is likely to be present. If VC further decreases to < 680 mL, patients may start to be hypercapnic by the end of the day despite treatment with effective N-NIPPV. Hypercapnia during the night (yielding N-NIPPV) and during the day (requiring D-NIPPV) is not entirely obtained from the same variables.
In DMD, distinction should be made between
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This work was performed at Inkendaal Rehabilitation Hospital, Neuromuscular Centre VUB-Inkendaal and Centre for Home Mechanical Ventilation.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).