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Diaphragm function and alveolar hypoventilation.

J Davis, M Goldman, L Loh

    The Quarterly Journal of Medicine
    |January 1, 1976
    PubMed
    Summary
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    Bilateral diaphragm paralysis causes alveolar hypoventilation, leading to impaired breathing, especially during sleep. Nighttime respirator use provided symptomatic relief for these patients.

    Area of Science:

    • Pulmonology
    • Neuromuscular Disorders

    Background:

    • Alveolar hypoventilation is a critical respiratory condition.
    • Bilateral diaphragm paralysis can significantly impair respiratory function.

    Purpose of the Study:

    • To investigate the syndrome of alveolar hypoventilation in patients with bilateral diaphragm paralysis.
    • To assess diaphragm function and its correlation with respiratory insufficiency.

    Main Methods:

    • Studied eight patients with suspected diaphragm weakness.
    • Quantitatively assessed diaphragm function using transdiaphragmatic pressure (deltaPDi).
    • Evaluated vital capacity, blood gases during rest, sleep, and response to CO2.

    Main Results:

    • Five patients had zero deltaPDi, indicating paralysis; others showed severe weakness.

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  • Vital capacity significantly decreased in the supine position.
  • Alveolar hypoventilation worsened during sleep and was associated with impaired CO2 response.

    • Conclusions:

    • Bilateral diaphragm paralysis is a significant cause of alveolar hypoventilation.
    • Diaphragm weakness leads to respiratory compromise, particularly in non-upright and sleeping positions.
    • Nocturnal cuirass ventilation offers symptomatic improvement for affected individuals.