Respiratory muscle dysfunction and chronic obstructive pulmonary disease.

The review presents literature data on the problem of respiratory muscle (RM) dysfunction in patients with chronic obstructive pulmonary disease (COPD). In the development of RM dysfunction, both local and systemic factors of the pathogenesis of COPD are important. Local factors are associated with lung remodelling and the need to overcome RM excessive breathing resistance, which increases the intensity of their work, contributes to the development of hypertrophy and insufficiency. Chronic systemic inflammation, oxidative stress, excessive proteolysis and other systemic manifestations of COPD change the metabolism and structural and functional organisation of RM. Low nutritional status, increasing protein-energy deficiency, electrolyte imbalance, endocrine disorders against the background of progressive respiratory insufficiency and tissue hypoxia contribute to the development of RM weakness. The combination of COPD, acute disorders of cerebral circulation and chronic heart failure sharply worsens the function of RM and the prognosis of comorbid diseases. Also, the dysfunction of RM in patients with COPD is significantly aggravated at the age of senility. The review discusses the possibilities of pharmacological correction of RM dysfunction and other clinical aspects of this problem.