Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học 'Respiratory Research cung cấp cho các bạn kiến thức về ngành y đề tài: " Diaphragm adaptations in patients with COPD. | Respiratory Research BioMed Central Review Open Access Diaphragm adaptations in patients with COPD Coen AC Ottenheijm 4 Leo MA Heunks1 2 3 and Richard PN Dekhuijzen1 3 Address 1Dept. of Pulmonary Diseases Radboud University Nijmegen Medical Centre Nijmegen The Netherlands 2Dept. of Intensive Care Medicine Radboud University Nijmegen Medical Centre Nijmegen The Netherlands 3Institute for Fundamental and Clinical Human Movement Sciences Radboud University Nijmegen Medical Centre Nijmegen The Netherlands and 4Dept. of Molecular and Cellular Biology University of Arizona Tucson USA Email Coen AC Ottenheijm - coeno@ Leo MA Heunks - Richard PN Dekhuijzen - Corresponding author Published 24 January 2008 Respiratory Research 2008 9 12 doi l465-992l-9-l2 Received 4 November 2007 Accepted 24 January 2008 This article is available from http content 9 l l2 2008 Ottenheijm et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Inspiratory muscle weakness in patients with COPD is of major clinical relevance. For instance maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm shortening. However more recently invasive evaluation of diaphragm contractile function structure and biochemistry demonstrated that cellular and molecular alterations occur of which several can be considered pathologic of nature. Whereas the fiber type shift towards oxidative type I fibers in COPD diaphragm is regarded beneficial rendering the overloaded diaphragm more resistant to fatigue the reduction of diaphragm fiber force
