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Semin Respir Crit Care Med 2009; 30(3): 275-292
DOI: 10.1055/s-0029-1222441
© Thieme Medical Publishers

Restrictive Chest Wall Disorders

Joseph Donath1 , 2 , 3 , Albert Miller1 , 4
  • 1Department of Medicine, St. John's Queens Hospital, Caritas Brooklyn-Queens Health Care, Elmhurst and Jamaica, New York
  • 2Current affiliations: New York Medical College, Valhalla, New York
  • 3Private practice, Forest Hills, New York
  • 4Mount Sinai School of Medicine, New York, New York
Further Information

Publication History

Publication Date:
18 May 2009 (online)

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ABSTRACT

Hypoventilation can be caused by diseases of the chest wall. Any anatomical or functional abnormality of the bony thorax increases dead space ventilation and the work of breathing, whether congenital or acquired, acute or chronic, and whether its cause is infectious, traumatic, environmental, iatrogenic, or unknown. In this article, we discuss these heterogeneous disorders from the viewpoint of the practicing nonpediatric pulmonary physician, only briefly touching on surgical, pediatric, rheumatologic, and other nonpulmonary ramifications. Emphasis is on the most common and the best researched forms of chest wall restriction, including kyphoscoliosis, fibrothorax, thoracoplasty, flail chest, and ankylosing spondylitis. Other diseases such as osteoporosis with its less well known pulmonary effects, and some rarely seen entities, are briefly discussed.

KEYWORDS

Chest wall - rib cage - kyphoscoliosis - fibrothorax - thoracoplasty - flail chest - ankylosing spondylitis - osteoporosis - mucopolysaccharidoses - hypoventilation - respiratory failure - pulmonary function

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