Respiratory muscle strength and maximal voluntary ventilation in undernourished patients

To assess the effect of chronic debilitation on respiratory muscle function, we studied 16 poorly nourished (PN) patients without pulmonary disease, and 16 well-nourished (WN) subjects matched for age and sex. Body weight, vital capacity (VC), maximal voluntary ventilation (MVV), and maximal static inspiratory and expiratory pressures (PImax and PEmax) were measured and expressed as percent predicted. Respiratory muscle strength (RMS) was calculated as (% PImax + % PEmax)2. Body weight was 71% predicted in the PN group and 104% in the WN group. The RMS, MVV, and VC were 37%, 41%, and 63%, respectively, of the values in the WN group (p less than 0.001). The 60% reduction in RMS was shared almost equally among inspiratory and expiratory muscles, and PEmax was linearly related to body weight. Because malnutrition reduces both respiratory muscle strength and MVV, it may well impair respiratory muscle capacity to handle increased ventilatory loads in thoracopulmonary disease.