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Diaphragmatic function in patients on continuous ambulatory peritoneal dialysis
T Wanke1, M Auinger, H Lahrmann
1Pulmonary Department, Lainz Hospital, Vienna, Austria.
Lung
|January 1, 1994
Summary
Continuous ambulatory peritoneal dialysis (CAPD) increases diaphragmatic strength but reduces neuromechanical efficiency. This study examined diaphragmatic function in CAPD patients with and without abdominal fluid.
Area of Science:
- Physiology
- Nephrology
- Respiratory Medicine
Background:
- Continuous ambulatory peritoneal dialysis (CAPD) is a treatment for kidney failure.
- The impact of CAPD on diaphragmatic function is not fully understood.
Purpose of the Study:
- To investigate diaphragmatic strength and neuromechanical efficiency in CAPD patients.
- To compare diaphragmatic function with a filled vs. empty abdomen.
Main Methods:
- Studied 8 CAPD patients.
- Measured maximal transdiaphragmatic pressure (Pdimax) for strength.
- Assessed neuromechanical efficiency using transdiaphragmatic pressure (Pdi) and diaphragmatic electromyogram (EMGdi) during breathing challenges.
Main Results:
- Pdimax increased significantly when the abdomen was filled with dialysate (P < 0.05).
- Diaphragmatic neuromechanical efficiency, assessed by EMGdi vs. Pdi slope, was significantly reduced with a filled abdomen (P < 0.05).
- Ventilatory responses to CO2 were similar in both conditions.
Conclusions:
- CAPD may induce adaptive changes in diaphragmatic force-length relationship.
- Despite increased strength, diaphragmatic neuromechanical efficiency is compromised in CAPD patients with a filled abdomen.