Journal of Applied Physiology AJP: Heart and Circulatory Physiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Appl Physiol 58: 1469-1476, 1985;
8750-7587/85 $5.00
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Laporta, D.
Right arrow Articles by Grassino, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Laporta, D.
Right arrow Articles by Grassino, A.

Journal of Applied Physiology, Vol 58, Issue 5 1469-1476, Copyright © 1985 by American Physiological Society

ARTICLES

Assessment of transdiaphragmatic pressure in humans

D. Laporta and A. Grassino

Maximal force developed by the diaphragm at functional residual capacity is a useful index to establish muscle weakness; however, great disparity in its reproducibility can be observed among reports in the literature. We evaluated five maneuvers to measure maximal transdiaphragmatic pressure (Pdimax) in order to establish best reproducibility and value. Thirty-five naive subjects, including 10 normal subjects (group 1), 12 patients with chronic obstructive pulmonary disease (group 2), and 13 patients with restrictive pulmonary disease (group 3), were studied. Each subject performed five separate maneuvers in random order that were repeated until reproducible values were obtained. The maneuvers were Mueller with (A) and without mouthpiece (B), abdominal expulsive effort with open glottis (C), two-step (maneuver C combined with Mueller effort) (D), and feedback [two-step with visual feedback of pleural (Ppl) and abdominal (Pab) pressure] (E). The greatest reproducible Pdimax values were obtained with maneuver E (P less than 0.01) (group 1: 180 +/- 14 cmH2O). The second best maneuvers were A, B, and D (group 1: 154 +/- 25 cmH2O). Maneuver C produced the lowest values. For all maneuvers, group 1 produced higher values than groups 2 and 3 (P less than 0.001), which were similar. The Ppl to Pdi ratio was 0.6 in maneuvers A and B, 0.4 in D and E, and 0.2 in C. We conclude that visual feedback of Ppl and Pab helped the subjects to elicit maximal diaphragmatic effort in a reproducible fashion. It is likely that the great variability of values in Pdimax previously reported are the result of inadequate techniques.


This article has been cited by other articles:


Home page
 Eur Respir JHome page
N. Terzi, D. Orlikowski, C. Fermanian, M. Lejaille, L. Falaize, A. Louis, J-C. Raphael, B. Fauroux, and F. Lofaso
Measuring inspiratory muscle strength in neuromuscular disease: one test or two?
Eur. Respir. J., January 1, 2008; 31(1): 93 - 98.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
F. Lofaso, F. Nicot, M. Lejaille, L. Falaize, A. Louis, A. Clement, J-C. Raphael, D. Orlikowski, and B. Fauroux
Sniff nasal inspiratory pressure: what is the optimal number of sniffs?
Eur. Respir. J., May 1, 2006; 27(5): 980 - 982.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
N. Pellegrini, P. Laforet, D. Orlikowski, M. Pellegrini, C. Caillaud, B. Eymard, J-C. Raphael, and F. Lofaso
Respiratory insufficiency and limb muscle weakness in adults with Pompe's disease
Eur. Respir. J., December 1, 2005; 26(6): 1024 - 1031.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. Spahija, M. de Marchie, and A. Grassino
Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD
Chest, August 1, 2005; 128(2): 640 - 650.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
V. A. DePalo, A. L. Parker, F. Al-Bilbeisi, and F. D. McCool
Respiratory muscle strength training with nonrespiratory maneuvers
J Appl Physiol, February 1, 2004; 96(2): 731 - 734.
[Abstract] [Full Text] [PDF]

Home page
 J. Neurol. Neurosurg. PsychiatryHome page
N Hart, M I Polkey, T Sharshar, L Falaize, B Fauroux, J C Raphael, and F Lofaso
Limitations of sniff nasal pressure in patients with severe neuromuscular weakness
J. Neurol. Neurosurg. Psychiatry, December 1, 2003; 74(12): 1685 - 1687.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
F. Garcia-Rio, J. M. Pino, A. Ruiz, S. Diaz, C. Prados, and J. Villamor
Accuracy of noninvasive estimates of respiratory muscle effort during spontaneous breathing in restrictive diseases
J Appl Physiol, October 1, 2003; 95(4): 1542 - 1549.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
M. Chatwin, E. Ross, N. Hart, A.H. Nickol, M.I. Polkey, and A.K. Simonds
Cough augmentation with mechanical insufflation/exsufflation in patients with neuromuscular weakness
Eur. Respir. J., March 1, 2003; 21(3): 502 - 508.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
ATS/ERS Statement on Respiratory Muscle Testing
Am. J. Respir. Crit. Care Med., August 15, 2002; 166(4): 518 - 624.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
N. Hart, M. I. Polkey, A. Clement, M. Boule, J. Moxham, F. Lofaso, and B. Fauroux
Changes in Pulmonary Mechanics with Increasing Disease Severity in Children and Young Adults with Cystic Fibrosis
Am. J. Respir. Crit. Care Med., July 1, 2002; 166(1): 61 - 66.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. Bellemare, M.-P. Cordeau, J. Couture, E. Lafontaine, P. Leblanc, and L. Passerini
Effects of Emphysema and Lung Volume Reduction Surgery on Transdiaphragmatic Pressure and Diaphragm Length*
Chest, June 1, 2002; 121(6): 1898 - 1910.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. OROZCO-LEVI, J. LLORETA, J. MINGUELLA, S. SERRANO, J. M. BROQUETAS, and J. GEA
Injury of the Human Diaphragm Associated with Exertion and Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., November 1, 2001; 164(9): 1734 - 1739.
[Abstract] [Full Text] [PDF]

Home page
 BrainHome page
R. A. Lyall, N. Donaldson, M. I. Polkey, P. N. Leigh, and J. Moxham
Respiratory muscle strength and ventilatory failure in amyotrophic lateral sclerosis
Brain, October 1, 2001; 124(10): 2000 - 2013.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. DIMITRIOU, A. GREENOUGH, G. F. RAFFERTY, and J. MOXHAM
Effect of Maturity on Maximal Transdiaphragmatic Pressure in Infants during Crying
Am. J. Respir. Crit. Care Med., August 1, 2001; 164(3): 433 - 436.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
A. Chetta, M.L. Harris, R.A. Lyall, G.F. Rafferty, M.I. Polkey, D. Olivieri, and J. Moxham
Whistle mouth pressure as test of expiratory muscle strength
Eur. Respir. J., April 1, 2001; 17(4): 688 - 695.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. SINDERBY, J. SPAHIJA, and J. BECK
Changes in Respiratory Effort Sensation Over Time Are Linked to the Frequency Content of Diaphragm Electrical Activity
Am. J. Respir. Crit. Care Med., March 15, 2001; 163(4): 905 - 910.
[Abstract] [Full Text]

Home page
 ChestHome page
M. I. Polkey and J. Moxham
Clinical Aspects of Respiratory Muscle Dysfunction in the Critically Ill
Chest, March 1, 2001; 119(3): 926 - 939.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. AL-BILBEISI and F. DENNIS McCOOL
Diaphragm Recruitment during Nonrespiratory Activities
Am. J. Respir. Crit. Care Med., August 1, 2000; 162(2): 456 - 459.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. N. Gwan-Nulla, W. R. Davidson Jr, R. T. Grenko, and R. J. Damiano Jr
Aortic dissection in a weight lifter with nodular fasciitis of the aorta
Ann. Thorac. Surg., June 1, 2000; 69(6): 1931 - 1932.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
J. M. Marin, M. Montes de Oca, J. Rassulo, and B. R. Celli
Ventilatory Drive at Rest and Perception of Exertional Dyspnea in Severe COPD
Chest, May 1, 1999; 115(5): 1293 - 1300.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
L. APPENDINI, A. PURRO, M. GUDJONSDOTTIR, P. BADERNA, A. PATESSIO, S. ZANABONI, C. F. DONNER, and A. ROSSI
Physiologic Response of Ventilator-dependent Patients with Chronic Obstructive Pulmonary Disease to Proportional Assist Ventilation and Continuous Positive Airway Pressure
Am. J. Respir. Crit. Care Med., May 1, 1999; 159(5): 1510 - 1517.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
Y. LANDO, P. M. BOISELLE, D. SHADE, S. FURUKAWA, A. M. KUZMA, J. M. TRAVALINE, and G. J. CRINER
Effect of Lung Volume Reduction Surgery on Diaphragm Length in Severe Chronic Obstructive Pulmonary Disease
Am. J. Respir. Crit. Care Med., March 1, 1999; 159(3): 796 - 805.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
D. S. TI and J.-W. F. TING
Sniff Nasal Inspiratory Pressure . Reference Values in Caucasian Children
Am. J. Respir. Crit. Care Med., January 1, 1999; 159(1): 107 - 111.
[Abstract] [Full Text]

Home page
 J. Appl. Physiol.Home page
C. Sinderby, J. Beck, J. Spahija, J. Weinberg, and A. Grassino
Voluntary activation of the human diaphragm in health and disease
J Appl Physiol, December 1, 1998; 85(6): 2146 - 2158.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
F. Laghi, A. Topeli, and M. J. Tobin
Does resistive loading decrease diaphragmatic contractility before task failure?
J Appl Physiol, September 1, 1998; 85(3): 1103 - 1112.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J. Beck, C. Sinderby, L. Lindstrom, and A. Grassino
Effects of lung volume on diaphragm EMG signal strength during voluntary contractions
J Appl Physiol, September 1, 1998; 85(3): 1123 - 1134.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. I. POLKEY, R. A. LYALL, M. GREEN, P. NIGEL LEIGH, and J. MOXHAM
Expiratory Muscle Function in Amyotrophic Lateral Sclerosis
Am. J. Respir. Crit. Care Med., September 1, 1998; 158(3): 734 - 741.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. M. TRAVALINE, S. SUDARSHAN, and G. J. CRINER
Recovery of PdiTwitch Following the Induction of Diaphragm Fatigue in Normal Subjects
Am. J. Respir. Crit. Care Med., November 1, 1997; 156(5): 1562 - 1566.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. M. TRAVALINE, S. SUDARSHAN, B. G. ROY, F. CORDOVA, V. LEYENSON, and G. J. CRINER
Effect of N-Acetylcysteine on Human Diaphragm Strength and Fatigability
Am. J. Respir. Crit. Care Med., November 1, 1997; 156(5): 1567 - 1571.
[Abstract] [Full Text]

Home page
 Am. J. Respir. Crit. Care Med.Home page
G. CRINER, F. C. CORDOVA, V. LEYENSON, B. ROY, J. TRAVALINE, S. SUDARSHAN, G. O'BRIEN, A. M. KUZMA, and S. FURUKAWA
Effect of Lung Volume Reduction Surgery on Diaphragm Strength
Am. J. Respir. Crit. Care Med., May 1, 1997; 157(5): 1578 - 1585.
[Abstract] [Full Text]

Home page
 LupusHome page
F. Munoz-Rodriguez, J. Font, J. Badia, C. Miret, J. Barbera, R. Cervera, and M. Ingelmo
Shrinking lungs syndrome in systemic lupus erythematosus: improvement with inhaled beta-agonist therapy
Lupus, January 1, 1997; 6(4): 412 - 414.
[Abstract] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Visit Other APS Journals Online