Sleep in critically ill chemically paralyzed patients requiring mechanical ventilation.

Objective: To determine sleep characteristics in patients receiving mechanical ventilation who require a neuromuscular blocking agent (NMBA).

Design: Observational study.

Setting: Adult medical ICU at a university hospital.

Severe upper airway obstruction during sleep.

Few disorders may manifest with predominantly sleep-related obstructive breathing. Obstructive sleep apnea (OSA) is a common disorder, varies in severity and is associated with significant cardiovascular and neurocognitive morbidity. It is estimated that between 8 and 18 million people in the United States have at least mild OSA.

Respiratory abdominal muscle recruitment and chest wall motion in myotonic muscular dystrophy.

Abdominal muscles are selectively active in normal subjects during stress and may increase the potential energy for inspiration by reducing the end-expiratory lung volume (EELV). We hypothesized that a similar process would occur in subjects with myotonic muscular dystrophy (MMD), but would be less effective, because of to their weakness and altered chest wall mechanics. Fine-wire electromyography (EMG) of the transversus abdominis (TA), internal oblique (IO), external oblique, and rectus abdominis was recorded in 10 MMD and 10 control subjects.

Predictors of loss of lung function in the elderly: the Cardiovascular Health Study.

Pulmonary function, as measured by spirometry (FEV1 or FVC), is an important independent predictor of morbidity and mortality in elderly persons. In this study we examined the predictors of longitudinal decline in lung function for participants of the Cardiovascular Health Study (CHS). The CHS was started in 1990 as a population-based observational study of cardiovascular disease in elderly persons.

Pursed lips breathing improves ventilation in myotonic muscular dystrophy.

Objective: To determine the effects of pursed lips breathing on ventilation, chest wall mechanics, and abdominal muscle recruitment in myotonic muscular dystrophy (MMD).

Design: Before-after trial.

Setting: University hospital pulmonary function laboratory.