Article

OBJECTIVE: To consider the effect of active lung volume recruitment ("air
stacking") on rate of decline in vital capacity.
DESIGN: Retrospective
cross-sectional design. PATIENTS: People with Duchenne muscular dystrophy.
METHODS: Vital capacity was measured at every patient visit and then graphed. Air
stacking using volume-preset ventilation or manual resuscitator bag was
introduced to all patients after their vital capacity plateaued (reached a
lifetime maximum). RESULTS: For 151 consecutive patients with multi-year data,
the 1-year rate of greatest decline in post-plateau vital capacity was 104 ml
(8.8%)/year and occurred from age 20 to 21 years. For 53 patients with
multi-visit data for whom air stacking was begun at the immediate post-plateau
visit, the 1-year rate of greatest decline in vital capacity was 118 ml (8.5%)
and occurred from age 20 to 21 years. Between annual visits, vital capacity and
maximum insufflation capacity increased 26.4% and 43.3% of the time,
respectively. The peak of maximal vital capacity decline occurred more than 5
years later than previously reported without air stacking. CONCLUSION: For
patients with Duchenne muscular dystrophy, active lung volume recruitment may
help to preserve vital capacity. Effects on post-plateau vital capacity may be a
useful outcome measure for therapeutic trials.

Langue : ANGLAIS