The effect of respiratory muscle weakness on the maximum static pressure-volume (PV) characteristics of the respiratory system was studied in four healthy males infused slowly with d-tubocurarine (dtc). Inspiratory capacity (IC), expiratory reserve volume (ERV), maximum static inspiratory and expiratory mouth pressures at four lung volumes, and handgrip were measured during induction of, and recovery from muscle weakness. The maximum effect of dtc varied among the muscle groups tested; peripheral muscles were most severely affected, expiratory muscles moderately, and inspiratory muscles least affected. At each level of weakness studied, decreases of IC and ERV were proportional to decreases of maximum static mouth pressures. Vital capacity, measured at each level of weakness was much less than values predicted from the static mechanical properties of the respiratory system. Our findings suggest that the marked change in the extremes of lung volume during submaximal neuromuscular blockade (SMNB) is due, in part, to unequal distribution of muscle weakness, reflected by decreased ability to change ribcage dimensions even at modest levels of SMNB.
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