Maximal Respiratory Mouth Pressures Assessment in Stable Chronic Obstructive Pulmonary Disease Patients in a Tertiary Hospital in Southwest Nigeria

Authors

  • Oluwafunmilayo Oguntoye Department of Medicine, Faculty of Clinical Science, Afe Babalola University Ado Ekiti, Ekiti State, 360001, Nigeria. and Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Gregory Erhabor Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, 220007, Nigeria.
  • Olufemi Adewole Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, 220007, Nigeria.
  • Olayemi Awopeju Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, 220007, Nigeria.
  • Bolanle Adefuye Department of Medicine, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, 121101, Nigeria.
  • Eruke Egbagbe Department of Medicine, University of Benin Teaching Hospital, Benin City, Edo State, 300001, Nigeria.
  • Temitope Kolawole Department of Medicine, Faculty of Clinical Science, Afe Babalola University Ado Ekiti, Ekiti State, 360001, Nigeria. and Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Oluwatosin Oguntoye Department of Medicine, Faculty of Clinical Science, Afe Babalola University Ado Ekiti, Ekiti State, 360001, Nigeria. and Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Abidemi Fasae Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Paul Olowoyo Department of Medicine, Faculty of Clinical Science, Afe Babalola University Ado Ekiti, Ekiti State, 360001, Nigeria. and Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Azeez Ibrahim Department of Medicine, Faculty of Clinical Science, Afe Babalola University Ado Ekiti, Ekiti State, 360001, Nigeria. and Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.
  • Adenike Arawomo Department of Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, 220007, Nigeria.
  • Oluwatosin Jegede United Nations Office on Drugs and Crime, Abuja, Federal Capital Territory, 900001, Nigeria.
  • Olumuyiwa Ariyo Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, 371101, Nigeria.

DOI:

https://doi.org/10.31584/jhsmr.2023993

Keywords:

COPD, maximal respiratory mouth pressure, PEmax, Plmax, respiratory muscle strength

Abstract

Objective: This study aimed to assess the respiratory muscle strength in stable chronic obstructive pulmonary disease (COPD) patients, via measuring maximal respiratory mouth pressures [maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax)] to determine its association with disease severity and quality of life.
Material and Methods: The study was a cross-sectional comparative study. A hundred and forty subjects (70 COPD patients and 70 controls) were recruited. Measurements of PImax, PEmax and spirometry were then performed. The health-related quality of life, severity of obstruction and dyspnea in the COPD patients were assessed using the COPD Assessment Test (CAT), post-bronchodilator Forced Expiratory Volume in 1 second (FEV 1) and the modified Medical Research Council (mMRC) dyspnea scale, respectively. Data was analyzed using Statistical Package for the Social Science (SPSS) version 25.0 (SPSS IL USA.).
Results: The mean (±S.D.) PImax and PEmax of the COPD patients (31.78±14.40 cmH2O and 54.80±18.89 cmH2O, respectively) were significantly lower (p<0.001) than the controls (80.40±7.50 cmH2O and 95.44±12.52 cmH2O, respectively). Both the PImax and PEmax correlated positively with the FEV1 of the COPD patients (r=0.658 and 0.534, respectively, p<0.001). The PImax and PEmax decreased as the mMRC dyspnea grade worsened (p<0.001). There was a negative correlation between PImax; PEmax and the CAT score of the COPD patients (r=-0.704 and–0.583, respectively, p<0.001).
Conclusion: There was significant respiratory muscle weakness in the COPD patients compared with the controls. The respiratory muscle weakness worsened as the airflow obstruction and dyspnea worsened. Respiratory muscle weakness may also add to the negative impact COPD has on the health status of COPD patients.

References

2021 global strategy for prevention, diagnosis and management of copd [homepage on the Internet]. Illinois: GOLD Inc; [cited 2021 May 27]. Available from: https://goldcopd.org/2021-gold-reports/

Mannino DM, Gagnon RC, Petty TL, Lydick E. Obstructive lung disease and low lung function in the united states:data from national health and nutrition examination survey, 1988-1994. Arch Intern Med 2000;160:1683–9.

Agusti AG. Systemic effects of Chronic Obstructive Pulmonary Disease. Proc AM Thorac So 2005;2:367–70.

Decramer M. The Respiratory Muscles in COPD: regulation of trophical status. Verh K Acad Geneeska Belg 2001;63:577–602.

Wouters E. Muscle wasting in chronic obstructive pulmonary disease to bother and to measure! Am J Respir Crit Care Med 2006;173:4–5.

Kabitz H-J, Walterspacher S, Walker D, Windisch W. Inspiratory muscle strength in chronic obstructive pulmonary disease depending on disease severity Inspiratory muscle strength in chronic obstructive pulmonary disease depending on disease severity. Clin Sci 2007;113:243–9.

Hamnegard C-H, Wragg S, Kyroussis D, Aquilina R, Moxham J, Green M. Portable measurement of maximum mouth pressures. Eur Respir J 1994;7:398–401.

Black LF, Hyatt RE. Maximal respiratory pressures: normal values and relationships to age and sex. Am Rev Respir Dis 1969;99:696–702.

ATS/ERS Statement on respiratory muscle tesing. Am J Respir Crit Care Med 2002;166:518–624.

Terzano C, Ceccarelli D, Conti V, Graziani E, Ricci A, Petroianni A. Maximal respiratory static pressures in patients with different stages of COPD severity. Respir Res 2008;9:1–7.

Leech J, Ghezzo H, Stevens D, Becklake M. Respiratory pressures and function in young adults. Am Rev Respir Dis 1983;128:17–23.

Bruschi C, Cerveri I, Zoia M, Fanfulla F, Fiorentini M, Casali L, et al. Reference values of maximal inspiratory mouth pressures: a population based study. Am Rev Respir Dis 1992;146:790–3.

Spruit MA, Singh SJ, Garvey C, Zuwallack R, Nici L, Rochester C, et al. American thoracic society documents an official american thoracic society/european respiratory society statement: key concepts and advances in pulmonary Rehabilitation Executive Summary. Am J Respir Crit Care Med 2013;188:e13-64.

Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019;200.

Rochester D. Malnutrition and the respiratory muscles. Clin Chest Med 1986;7:91–9.

Van Balkom RH, Zhan W-Z, Prakash Y, Richard Dekhuijzen P, Sieck GC. Corticosteroids effects on isotonic contractile properties of rat diaphragm muscle. J Appl Physiol 1997;83:1062–7.

Nishimura Y, Tsutsumi M, Nakata H, Tsunenari T, Maeda H, Yokoyama M. Relationship between respiratory muscle strength and lean body mass in men with copd. Chest 1995;107:1232–6.

Heijdra Y, Dekhuijzen P, Van Herwaarden C, Folgering H. Effects of body position , hyperinflation , and blood gas tensions on maximal respiratory pressures in patients with chronic obstructive pulmonary disease. Thorax 2014;49:453–8.

Agusti A, Calverley PMA, Celli B, Coxson HO, Edwards LD, Lomas DA, et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010;11:122–36.

Martinez-Garcia M-A, de la Rosa D, Soler-Cataluna J-J, Donat-sanz Y, Serra CP, Lerma MA, et al. Prognostic value of bronchiectasis in patients with moderate-to-severe chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2013;187:823–31.

Nambiar VK, Ravindra S, Nanda Kumar BS. Maximal inspiratory and expiratory pressures in men with chronic obstructive pulmonary disease: a cross-sectional study. Indian J Respir Care 2018;7:88–92.

Nam-Sik K, Jeong-Hwan S, Myoung-Hwan K, Sung-Hee P, Yu HW. Respiratory muscle strength in patients with chronic obstructive pulmonary disease. Ann Rehabil Med 2017;41:659–66.

Polkey M, Green M, Moxham J. Measurement of respiratory muscle strength. Thorax 1995;50:1131–5.

Sze MA, Dimitriu PA, Suzuki M, Mcdonough JE, Campbell JD, Brothers JF, et al. Host response to the lung microbiome in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2015;192:438–45.

Hogg JC, Timens W. The Pathology of chronic obstructive pulmonary disease. Annu Rev Pathol 2009;4:435–59.

Barrett Kim E, Barman Susan M, Boitano Scott, Brooks Heddwen L. Ganong’s Review of Medical Physiology. 23rd ed. Singapore: McGraw-Hill; 2010. p.587–607.

Hogg JC, Macklem PT, WM T. Site and nature of airways obstruction in chronic obstructive lung disease. N Engl J Med 1968;278:1355–60.

Saetta M, Turato G, Baraldo S, Zanin A, Braccioni F, Mapp CE, et al. Goblet cell hyperplasia and epithelial inflammation in peripheral airways of smokers with both symptoms of chronic bronchitis and chronic airflow limitation. Am J Respir Crit Care Med 2000;161:1016–21.

Dyspnea. Mechanisms, assessment and management: a consensus statement. American Thoracic Society. Am J Respir Crit Care Med 1999;159:321–40.

Hyatt R. Expiratory flow limitation. J Appl Physiol 1983;55:1–7.

Vyas PK, Bindroo PS, Gondha M, Mathur RS, Ghtawat G, Lakkappan V. Measurement of maximal respiratory static pressure in stable copd patients and their co-rrelation with various physiological anthropometric and spirometry parpmeters and arterial blood gas tension. Arch Pulmonol Respir Care 2020;6:33–42.

Rochester D, Braun N. Determinants of maximal inspiratory pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis 1985;132:42–7.

Orozco-Levi M. Structure and function of the respiratory muscles in patients with COPD: impairment or adaptation? Eur Respir J 2003;22:S41-51.

Launois C, Barbe C, Bertin E, Nardi J, Perotin J, Dury S, et al. The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: a pilot study. BMC Pulm Med 2012;12:61.

O’Donnell DE, Banzett RB, Carrieri-Kohlman V, Casaburi R, Davenport PW, Gandevia SC, et al. Pathophysiology of dyspnea in chronic obstructive pulmonary disease a roundtable. Proc Am Thorac Soc4 2007;4:145–68.

Charususin N, Dacha S, Gosselink R, Decramer M, Leupoldt A Von, Reijnders T, et al. Respiratory muscle function and exercise limitation in patients with chronic obstructive pulmonary disease: a review. Expert Rev Respir Med 2018;12:67–79.

Khalil M, Wagih K, Mahmoud O. Evaluation of maximum inspiratory and expiratory pressure in patients with chronic obstructive pulmonary disease. Egypt J Chest Dis Tuberc 2014;63:329–35. doi: 10.1016/j.ejcdt.2014.01.010

Bove DG, Lavesen M, Lindegaard B. Characteristics and health related quality of life in a population with advanced chronic obstructive pulmonary disease, a cross- sectional study. BMC Palliat Care 2020;19:1–9.

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Published

2024-01-31

How to Cite

1.
Oguntoye O, Erhabor G, Adewole O, Awopeju O, Adefuye B, Egbagbe E, Kolawole T, Oguntoye O, Fasae A, Olowoyo P, Ibrahim A, Arawomo A, Jegede O, Ariyo O. Maximal Respiratory Mouth Pressures Assessment in Stable Chronic Obstructive Pulmonary Disease Patients in a Tertiary Hospital in Southwest Nigeria. J Health Sci Med Res [Internet]. 2024 Jan. 31 [cited 2024 Jul. 18];42(2):e2023993. Available from: https://he01.tci-thaijo.org/index.php/jhsmr/article/view/268633

Issue

Vol. 42 No. 2 (2024): Mar-Apr

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Original Article

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