The Assessment of Effects of Noninvasive Mechanical Ventilation Application on Markers of Muscle Injury and Ischemia

Havva Şahin 1, Mehmet Yavşan 2, Aysun Toker 1, Erkan Taşyürek 1, Mustafa Tosun 2, Turgut Teke 2, Kürşat Uzun 2, Haluk Dülger 1 *
More Detail
1 N.E.Ü. Meram Tıp Fakültesi Tıbbi Biyokimya Anabilim Dalı, Konya, Türkiye
2 N.E.Ü. Meram Tıp Fakültesi Göğüs Hastalıkları Anabilim Dalı, Konya, Türkiye
* Corresponding Author
EUR J BASIC MED SCI, Volume 4, Issue 2, pp. 29-36. https://doi.org/10.15197/sabad.2.4.06
OPEN ACCESS
Download Full Text (PDF)

ABSTRACT

The noninvasive mechanical ventilation (NIMV) is widely used for the treatment of the patients’ chronic obstructive pulmonary disease (COPD) and respiratory failure. noninvasive mechanical ventilationis effective in increasing the ventilation of the lungs and decreasing the work of the heart on the left ventricle and the consumption of the oxygen. In spite of the positive effects of the noninvasive mechanical ventilationtreatment, an increase of cardiac damage is seen in the patients . The aim of this study is to search certain ischemia markers in order to assess and measure the impact of this treatment on the striated muscle and the cardiac muscle of the patients who have been tied to the noninvasive mechanical ventilator, due to their suffering from the difficulty of breathing.
With this objective, 64 patients with the diagnosis of COPD are included in this research, and they are divided into two groups. Group I (control group, n=31) consists of the patients who are suffering from mild respiratory failure and not connected to the ventilator. The patients with the severe respiratory failure, prior to their being tied to the ventilator, constitute Group II (before ventilation (vö)) (n=33), after their having been connected to the ventilator (3rd day), are the members of Group II (after ventilation (vs)) (n=33). The levels of blood pH, pO2 and pCO2, serum troponin, myoglobin, creatine kinase (CK), CKMB, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), albumin, and the ischemia modified albumin (IMA) have been measured in the patients.
The level of serum troponin has been observed higher in prior to NIMV (Group II (vö)) than control group (Group I). Likewise, it has been noted significant increase in group after NIMV (Group II (vs)). Serum AST and IMA has also been seen a significant increase in group after NIMV (Group II (after)) as compared to the control group (Group I). There was no significant difference among the groups at the levels of serum myoglobin, CK-MB, ALT, CK, LDH (p>0.05).
It was concluded that, depending on the severity of respiratory failure, that are markers of ischemia, serum troponin, AST and IMA levels increased, NIMV application contributed to this increase is limited and cardiac function more careful should be followed during the non-invasive mechanical ventilation application.
Keywords: ischemia, IMA, cardiac damage, NIMV, troponin

CITATION

Şahin H, Yavşan M, Toker A, Taşyürek E, Tosun M, Teke T, et al. The Assessment of Effects of Noninvasive Mechanical Ventilation Application on Markers of Muscle Injury and Ischemia. Eur J Basic Med Sci. 2014;4(2):29-36. https://doi.org/10.15197/sabad.2.4.06

REFERENCES

  • Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, et al. Noninvasive Ventilation for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. N Engl J Med 1995;333: 817-22.
  • Plant PK, Owen JL, Elliott MW. Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax 2001;56:708-12.
  • Teke T, Maden E, Kıyıcı A, Yavşan DM, Çiçek H, Uzun K. Hiperkapnik Solunum Yetmezliği Gelişen KOAH’lı Hastalarda Non-İnvaziv Ventilasyonun Plazma Brain Natriüretik Peptid (BNP) ve Troponin Üzerine Etkisi. Selçuk Üniv Tıp Derg 2011;27: 142-5.
  • Baratz DM, Westbrook PR, Shah PK, Mohsenifar Z. Effect of nasal continuous positive airway pressure on cardiac output and oxygen delivery in patients with congestive heart failure. Chest 1992;102: 1397-401.
  • Peter JV, Moran JL, Phillips-Hughes JK, Graham P, Bersten AD. Effect of noninvasive positive pressure ventilation (NIPPV) on mortality in patients with acute cardiogenic pulmonary oedema: a meta-analysis. Lancet 2006;367:1155-63.
  • Adams JE, Bodor GS, Davila-Roman VG, Delmez JA, Apple FS, Ladenson JH, etal. Cardiac troponin-I. A marker with high specificity for cardiac injury. Circulation 1993;88:101-6.
  • Clarkson PM, Hubal MJ. Exercise-induced muscle damage in humans. Am J Phys Med Rehabil 2002; 81(11 Suppl):52-69.
  • Brancaccio P, Lippi G, Maffulli N. Biochemical markers of muscular damage. Clin Chem Lab Med 2010;48:757-67.
  • Jürgens KD, Papadopoulos S, Peters T, Gros G. Myoglobin: Just an oxygen store or also an oxygen transporter? News Physiol Sci 2000;15: 269-74.
  • Koç F, Erdem S, Altunkaş F, Özbek K, Gül EE, Kurban S, Taşyürek E, Erbay E, Söğüt E. Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study. Anadolu Kardiyol Derg 2011;11: 582-7.
  • Bar-Or D, Lau E, Winkler JV. Novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia preliminary report. J Emerg Med 2000;19:311-5.
  • Global Initiative for Chronic Obstructive Lung Disease (Gold) Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. 2011 (update). http://www.goldcopd.org/uploads/users/files/GOLD_Report_2011_Jan21.pdf
  • Keenan SP, Mehta S. Noninvasive ventilation for patients presenting with acute respiratory failure: the randomized controlled trials. Respir Care 2009;54:116-26.
  • Uzun K, Duran Ü, Teke T. Noninvaziv mekanik ventilasyonun mortaliteye etkisi ve başarıyı etkileyen faktörler. Genel Tıp Derg 2011;21(2): 57-63.
  • Agarwal R, Aggarwal AN, Gupta D. Role of noninvasive ventilation in acute lung injury/acute respiratory distress syndrome: a proportion meta-analysis. Respir Care 2010;55:1653-60.
  • Türk Kardiyoloji Derneği Arştırması. Üçüncü Evrensel Miyokart Enfarktüsü Tanımı (TKD) 2013, Suppl.3 http://www.tkd.org.tr.kilavuzlari/tkda_2013_41_suppl_3_129_145.pdf
  • Gürger M, Bozdemir MN, Yıldız M, Gürger M, Özden M, Bozgeyik Z, Dağlı MN. Acil servise iskemik inme nedeniyle başvuran hastalarda hastane içi mortalitenin belirlenmesinde kardiyak belirteçlerin rolü. Türkiye Acil Tıp Dergisi 2008;8(2):59-66.
  • Meriç M. ST yükselmesi olmayan akut koroner sendromlar. Deneysel ve Klinik Tıp Dergisi 2012; (29): 133-9.
  • Deveci F, Turgut T, Tuğ T, Kırkıl G, Türkoğlu S, Muz MH. KOAH’lı olgularda kardiyak troponin düzeyleri. Türkiye Toraks Dergisi 2006; 7(2): 95-100.
  • Burtis CA, Ashwood ER (eds). Klinik Kimyada Temel İlkeler 5. Baskıdan Çeviri. Çeviri Ed: Aslan D. Palme Yayıncılık, Ankara, 2005;33: 688-95.
  • Güzel N, Eler S. Bir müsabaka süresince elit erkek plaj hentbol oyuncularının kan glikoz, laktat ve kreatin kinaz düzeylerindeki değişimler. Fizyoterapi Rehabilitasyon Dergisi 2003;1: 25-32.
  • Sonsuz A. Karaciğer fonksiyon bozukluklarına klinik yaklaşım. Türkiyede Sık Karşılaşılan Hastalıklar II’de. Ed. Dobrucalı A, Tetikkurt C. İ.Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri Sempozyum Dizisi, İstanbul, 2007; 58:69-78.
  • Öztabak K, Mengi A. Lektin Verilen Normal ve Tümörlü Farelerde Serum, Karaciğer ve Böbrek AST, ALT, GGT, ALP, CK Aktiviteleri. J Fac Vet Med 2004; 1-2-3: 93-7.
  • Vasil’eva EV, Lopatkin ON, Koylov AV, Morozov IuE. Diagnostic role of organ-specific isoform of lactate dehydrogenase in blood plasma. Sud Med Eksport 2005;48:23-6.
  • Bar-Or D, Winkler JV, Vanbenthuysen K, Haris L, Lau E, Hetzel FW. Reduced albumin-cobalt binding with transient myocardial ischemia after elective percutaneous transluminal coronary angioplasty: a preliminary comparison to creatine kinase-MB, myoglobin and troponin I. Am Heart J 2001;141: 985-91.
  • Sinha MK, Roy D, Gaze DC, Collinson PO, Kaski JC. Role of “Ischemia modified albumin”, a new biochemical marker of myocardial ischaemia, in the early diagnosis of acute coronary syndromes. Emerg Med J 2004;21:29-34.
  • Consuegra-Sanchez L, Bouzas-Mosquera A, Sinha MK, Collinson PO, Gaze DC, Kaski JC. Ischemia-modified albumin predicts short-term outcome and 1-year mortality in patients attending the emergency department for acute ischemic chest pain. Heart Vessels 2008;23:174-80.
  • Hjortshøj S, Kristensen SR, Ravkilde J. Diagnostic value of ischemia-modified albumin in patients with suspected acute coronary syndrome. Am J Emerg Med 2010;28:170-6.