Neuromuscular

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RESPIRATORY FAILURE: Early or Selective

Causes
  Adult onset
  Infantile onset
Evaluation & Management
Exacerbating factors
Home ventilation
Spirometric abnormalities
Elevated right
hemidiaphragm



Respiratory involvement: Adult onset

Respiratory insufficiency: Infantile & Childhood


Respiratory failure: Evaluation & Management


Respiratory failure: Exacerbating factors



PATTERNS OF SPIROMETRIC ABNORMALITIES
Obstructive Diseases Restrictive Diseases
FVC Normal or to
FEV1 to to
FEV1 /FVC to Normal or
FEF25%-75% to to

Restrictive ventilatory defects are characterized by proportional decreases in FVC and FEV1, leaving the FEV1/FVC normal or even slightly elevated. Any lesion affecting the lung, chest wall, or respiratory muscles that reduces the ability to take in a normal amount of air but does not affect the conducting airways is classified as a restrictive lung disease.

Obstructive defects are characterized by their involvement of the airways and the resultant reduction in expiratory flow. Spirometric studies of obstructive lung disease generally show a reduced FEV1, FEV1/FVC and flow rates with a relatively normal FVC. In severe obstructive lung disease, the FVC may also be reduced.


Home ventilation: Types

Pressure-limited: BiPAP Volume-limited

MYOSIN-LOSS (Acute Quadriplegic; Critical Illness) MYOPATHIES 2



Cough & Neuromuscular Disorders 6



Hoarse voice & Neuromuscular Disorders


Phrenic Neuropathy

Phrenic nerve Phrenic Nerve Disorders
Return to Neuropathy Index
Return to Myopathy & NMJ Index


References
1. J Neurol Neurosurg Psychiatry 1999;67:223-226
2. Muscle Nerve 2000;23:1785-1788
3. Intensive Care Medicine 2003;Online August
4. Ann Neurol 2004;55:195-206
5. Respir Care 2015 Jan 13
6. Pulm Pharmacol Ther 2015 Oct 19

1/5/2017