{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:23:46Z","timestamp":1791221026215,"version":"4.1.0"},"reference-count":22,"publisher":"American Physiological Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:p> Respiratory muscle weakness is common in children with neuromuscular disease (NMD). We hypothesized that weakness puts them at risk for respiratory muscle fatigue, a harbinger of chronic respiratory failure. We therefore measured a noninvasive index of respiratory muscle fatigue, the tension-time index of the respiratory muscles (TT<jats:sub>mus<\/jats:sub>), in 11 children with NMD and 13 control subjects. Spirometric flow rates and maximal inspiratory pressure were significantly lower in the NMD group than in controls (43 \u00b1 23 vs. 99 \u00b1 21 cmH<jats:sub>2<\/jats:sub>O, P &lt; 0.001). The mean TT<jats:sub>mus<\/jats:sub> was significantly higher in the NMD group than in controls (0.205 \u00b1 0.117 vs. 0.054 \u00b1 0.021, P &lt; 0.001). The increase in TT<jats:sub>mus<\/jats:sub> was primarily due to an increase in the ratio of average mean inspiratory pressure to maximal inspiratory pressure, indicating decreased respiratory muscle strength reserve. We found a significant correlation between TT<jats:sub>mus<\/jats:sub> and the residual volume-to-total lung capacity ratio ( r = 0.504, P = 0.03) and a negative correlation between TT<jats:sub>mus<\/jats:sub> and forced expiratory volume in 1 s ( r = -0.704, P &lt; 0.001). In conclusion, children with NMD are prone to respiratory muscle fatigue. TT<jats:sub>mus<\/jats:sub> may be useful in assessing tolerance during weaning from mechanical ventilation, identifying impending respiratory failure, and aiding in the decision to institute therapies. <\/jats:p>","DOI":"10.1152\/japplphysiol.01087.2002","type":"journal-article","created":{"date-parts":[[2015,3,3]],"date-time":"2015-03-03T20:46:24Z","timestamp":1425415584000},"page":"931-937","source":"Crossref","is-referenced-by-count":49,"title":["Noninvasive measurement of the tension-time index in children with  neuromuscular disease"],"prefix":"10.1152","volume":"95","author":[{"given":"Laura T.","family":"Mulreany","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, and  University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania  19104"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Weiner","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, and  University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania  19104"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"McDonough","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, and  University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania  19104"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard B.","family":"Panitch","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, and  University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania  19104"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian L.","family":"Allen","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, and  University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania  19104"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"REF1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/136.5.1285"},{"key":"REF2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1982.53.5.1190"},{"key":"REF3","unstructured":"Black LF and  Hyatt RE. 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