Abstract
Changes in intrapleural pressure (ΔPpl) and abdomen pressure (ΔPab) were related to changes in the anterior-posterior diameter of the rib cage (ΔRC) and abdomen (ΔAb) in 17 patients with chronic obstructive pulmonary disease (COPD).ΔPab-ΔPpl equalsΔPdi, the change in transdiaphragmatic pressure. Measurements were made during quiet inspiration in the semierect position.ΔAb/(ΔAb+ΔRC) was used as a measure of relative abdomen motion, andΔPab/ΔPdi was used as a measure of the relative contribution of descent of the diaphragm to the breathing process. Patients with COPD developed greater ΔPdi than normal subjects. This increasedΔPdi was the result of relatively more intercostal and accessory muscle activity rather than increased diaphragm motion. Despite this, patients with COPD showed the same relative abdomen motion as did normal subjects. Observation of relative chest and abdomen motion in patients with COPD is a poor guide to relative use of the rib cage muscles and diaphragm.
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