Results of respiratory muscle strength study in young persons with community-acquired pneumonia
Aim. To evaluate the strength of the respiratory muscles (RM) in young people with community-acquired pneumonia (CAP) of varying severity and the completeness of its recovery during convalescence. Materials and methods. The study involved 104 men aged 18-23 years who were in hospital with a diagnosis of CAP. Non-severe CAP was diagnosed in 78 (75%) patients and severe CAP in 26 (25%). The strength indices of expiratory and inspiratory RM were recorded on a MicrоRPM device (CareFusion, Great Britain) at the height of the disease and during the period of convalescence. Anthropometric indicators were measured, the mass of skeletal muscles (MSM) was calculated according to the formula of J.Mateika, the ratio of MSM to total body mass (TBM), expressed as a percentage, is determined. The degree of fatigue of RM was studied by means of loading tests on incentive spirometer with adjustable expiratory and inspiratory resistance TheraPEP and Coach 2 (Smiths Medical, Great Britain). The fatigue index (FI) of expiratory and inspiratory RM was calculated as the ratio of the difference in the strength of the RM before and after the load to the initial value, expressed as a percentage. Results. At the height of the disease, the average values of the power characteristics of RM in patients with severe CAP compared to non-severe CAP shifted toward lower values. Moreover, the severity of the dysfunction of expiratory RM was more noticeable in comparison with inspiratory ones. The direct dependence of RM strength indicators on MSM was established. In convalescents, with an increase in MSM, a decrease in the FI was recorded, which demonstrated a greater resistance of RM to resistive breathing in this category of patients. Conclusion. The functional status of RM depends on the severity of CAP, but also on MSM, which indicates the important role of the muscle component in providing pulmonary ventilation. The use of adjustable expiratory and inspiratory resistance tests is a useful tool for assessing the completeness of the strength recovery of the RM after having CAP.