Adaptations in the diaphragm's in vivo force-length relationship in patients on continuous ambulatory peritoneal dialysis

David J. Prezant, T. K. Aldrich, J. P. Karpel, R. I. Lynn

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

In patients on continuous ambulatory peritoneal dialysis (CAPD) for more than 6 wk, we measured functional residual capacity (FRC), maximum inspiratory and transdiaphragmatic pressure, diaphragm length, and radius of curvature (roentgenographic methods) as functions of the volume of peritoneal dialysate (PD) instilled within the abdominal cavity. This allowed in vivo characterization of the human diaphragm's force-length relationship. As PD volume increased from zero to 3 L, FRC decreased from 2.41 ± 0.29 L to 1.93 ± 0.072 L; mean total diaphragm length index (TDLI) increased efrom 0.22 ± 0.01 to 0.28 ± 0.01, and diaphragm radius of curvature remained unchanged. Respiratory muscle strength increased as a function of dialysate volume, reaching its maximum after the infusion of 3 L PD. In contrast, normal subjects achieved maximal inspiratory muscle force at their normal FRC, with a mean TDLI of 0.26 ± 0.01 and showed no further increase as the diaphragm lengthened. We conclude that the human diaphragm may be capable of an adaptive rightward shift in its force-length relationship when it is chronically lengthened by CAPD.

Original languageEnglish (US)
Pages (from-to)1342-1349
Number of pages8
JournalAmerican Review of Respiratory Disease
Volume141
Issue number5 I
StatePublished - 1990

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Continuous Ambulatory Peritoneal Dialysis
Diaphragm
Dialysis Solutions
Functional Residual Capacity
Respiratory Muscles
Abdominal Cavity
Muscle Strength
Muscles

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Adaptations in the diaphragm's in vivo force-length relationship in patients on continuous ambulatory peritoneal dialysis. / Prezant, David J.; Aldrich, T. K.; Karpel, J. P.; Lynn, R. I.

In: American Review of Respiratory Disease, Vol. 141, No. 5 I, 1990, p. 1342-1349.

Research output: Contribution to journalArticle

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