Am. J. Respir. Crit. Care Med., Volume 160, Number 5, November 1999, 1762-1765

Respiratory Muscle Strength in Cushing's Syndrome

GARY H. MILLS, DIMITRIS KYROUSSIS, PAUL JENKINS, CARL-HUGO HAMNEGARD, MICHAEL I. POLKEY, JOHN WASS, G. MICHAEL BESSER, JOHN MOXHAM, and MALCOLM GREEN

Respiratory Muscle Laboratory, Department of Thoracic Medicine, Royal Brompton Hospital, Department of Endocrinology, St. Bartholomew's Hospital, and Respiratory Muscle Laboratory, Department of Thoracic Medicine, King's College Hospital, London, United Kingdom; and Department of Pulmonary Medicine and Clinical Physiology, Sahlgrenska University Hospital, Goteborg, Sweden

The effect of Cushing's syndrome on respiratory muscle strength is unknown. Therefore, we studied 10 consecutive patients with severe Cushing's syndrome. The respiratory muscles were assessed using maximal inspiratory and expiratory mouth pressures (MIP, MEP), maximal sniff transdiaphragmatic pressures (max sniff Pdi), and maximal sniff esophageal pressures (max sniff Pes). Maximal quadricep strength was also assessed. The patients demonstrated an overall mean MIP 92 cm H₂O, SD 19 (mean 105% of predicted; SD, 23%), mean MEP 134 cm H₂O, SD 35 (mean 99% of predicted; SD, 25%), mean max sniff Pdi 107 cm H₂O, SD 12 (mean 78% of predicted; SD, 10%) and mean max sniff Pes of 92 cm H₂O, SD 11 (mean 92% of predicted; SD, 11%). Quadriceps muscle strength was reduced in all 10 patients: mean 26 kg, SD 9 (mean 49% of predicted strength, SD 21%). Respiratory muscle weakness was not found, despite the presence of severe quadriceps impairment. We conclude that major weakness of the respiratory muscles is not usual in Cushing's syndrome. Mills GH, Kyroussis D, Jenkins P, Hamnegard C-H, Polkey MI, Wass J, Besser GM, Moxham J, Green M. Respiratory muscle strength in Cushing's syndrome.

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