Respiratory muscle rest.

Abstract

The respiratory muscles have great reserves, and under normal circumstances, in a fit person, it is probably impossible to fatigue them by activity. However, respiratory muscle fatigue can be induced experimentally, and with the stress of pulmonary disability, or with impairment of muscle function due to neuromuscular disease or skeletal deformity. Respiratory muscle fatigue contributes to respiratory failure and clinical deterioration. Resting the respiratory muscles can allow time for recovery but requires complete or partial artificial ventilation. Whilst positive pressure ventilation has been carried out for many years in Intensive Care Units, this technique is difficult in the long-term. Recently there has been renewed interest in non-invasive ventilatory support. Nocturnal ventilation in an iron lung can cause long-term improvement in acute and chronic respiratory failure of patients with neuromuscular or skeletal abnormalities. Such patients may be maintained with devices at home, such as a pneumosuit, a cuirass, or positive pressure ventilation via the nose. In patients with chronic pulmonary disease respiratory muscle rest may be helpful during acute exacerbations. However, the value of rest in chronic respiratory failure of end-stage pulmonary patients is as yet unproven.