Spirometry using facemask versus conventional tube in patients with neuromuscular disorders

Abstract

BackgroundRespiratory derangement is a major health hazard in patients with neuromuscular disorders (NMD). This study aimed to compare spirometry results using facemask with that of conventional tube in patients with NMD and accordingly possible use of facemask instead of conventional tube in this group of patients. MethodsThirty-six patients with NMD and fifty normal volunteers were recruited within 9months. Assessment of patients included history and physical examination specially presence of respiratory symptoms, duration and stage of neuromuscular illness, bulbar symptoms, sensory, motor and cranial nerve assessment. Then all participants were subjected to spirometry and respiratory pressures assessment using both conventional tube and facemask. ResultsSpirometry and respiratory pressure assessment using facemask versus tube measured in all participants. For patients with NMD; spirometric measures PImax and PEmax were higher in tube than facemask. FEV1, FEV1%, FEV1/FVC %, and PImax showed statistically significant difference. For patients with bulbar palsy; SVC was higher in facemask without statistically significant difference. For other spirometric measures, PImax and PEmax; using tube was higher than facemask with only FEV1, FEV1% showed statistically significant difference (p=0.023 and 0.015 respectively). For patients without bulbar palsy; all spirometric measures, PImax and PEmax were higher when using tube with only FEV1/FVC % showed statistically significant difference (p=0.004). Also for control group; data were higher in tube with only FEV1 showed statistically significant difference (p=0.031). For patients with NMD; fractional functional defect (FFD) was very high for PImax and PEmax. ConclusionThe use of facemask during assessment of spirometric and respiratory pressures measures in patients with NMD and more specifically in patients with bulbar palsy is promising and can be considered a good alternative to conventional tube assessment for functional screening rationale.