<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0120-5633</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Colomb. Cardiol.]]></abbrev-journal-title>
<issn>0120-5633</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Colombiana de Cardiologia. Oficina de Publicaciones]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-56332016000500420</article-id>
<article-id pub-id-type="doi">10.1016/j.rccar.2016.05.014</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Disfunción muscular respiratoria en pacientes llevados a cirugía cardiovascular]]></article-title>
<article-title xml:lang="en"><![CDATA[Respiratory muscle dysfunction in patients undergoing cardiovascular surgery.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cáceres]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3 "/>
<xref ref-type="aff" rid="Af4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Meneses]]></surname>
<given-names><![CDATA[Karenth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Sarmiento]]></surname>
<given-names><![CDATA[Alba]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez]]></surname>
<given-names><![CDATA[Clara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A4"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bermon]]></surname>
<given-names><![CDATA[Anderson]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Figueredo]]></surname>
<given-names><![CDATA[Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte]]></surname>
<given-names><![CDATA[Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orozco-Levi]]></surname>
<given-names><![CDATA[Mauricio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A a"/>
<xref ref-type="aff" rid="A3 "/>
<xref ref-type="aff" rid="Af4"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Floridablanca Santander]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Floridablanca Santander]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,CEXS-Universidad Pompeu Fabra  ]]></institution>
<addr-line><![CDATA[Barcelona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Cod. COLCIENCIAS COL01372334  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Autónoma de Bucaramanga  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Fundación Cardiovascular de Colombia  ]]></institution>
<addr-line><![CDATA[Floridablanca Santander]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Universidad de Santander  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,CIBER de Enfermedades Respiratorias, ISCIII  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>23</volume>
<numero>5</numero>
<fpage>420</fpage>
<lpage>426</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-56332016000500420&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-56332016000500420&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-56332016000500420&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Objetivo: Evaluar la presencia de las alteraciones en la fuerza muscular respiratoria en pacientes programados para la cirugía cardiovascular, el impacto de la cirugía sobre la función muscular respiratoria y su relación con las alteraciones ventilatorias en el postoperatorio mediato.  Métodos: Estudio observacional prospectivo. Se realizaron pruebas de funcionalismo respiratorio (espirometría) y pruebas de fuerza muscular respiratoria (inspiratoria: presión inspiratoria máxima y espiratoria: presión espiratoria máxima) en dos momentos: preoperatorio inmediato (2 ± 1 días precirugía) y postoperatorio mediato (2 ± 1 días, antes del alta). Las complicaciones respiratorias incluyeron: la ventilación mecánica prolongada, el tromboembolismo pulmonar, el neumotórax, el hemotórax, la neumonía, el derrame pleural, el edema pulmonar y las atelectasias.  Resultados: Se evaluaron 30 pacientes adultos (n = 30) (62 ± 12 años). En el preoperatorio la capacidad espirométrica disminuyó en un 54% (35% alteración obstructiva, 19% no- obstructiva) y la debilidad inspiratoria y espiratoria fue confirmada en un 67 y 100%, respectivamente. Las complicaciones respiratorias estuvieron presentes en un 93% (con mayor frecuencia la atelectasia y el derrame pleural). El deterioro postoperatorio grave de la presión inspiratoria máxima incrementó 10 veces el riesgo de atelectasia (OR = 10, IC 95% 0,85-117,02; p = 0,067). Al alta, la fracción de eyección del ventrículo izquierdo fue 29% menor, la capacidad vital forzada -32%, la presión inspiratoria máxima -32% y la presión espiratoria máxima -32% con respecto al valor inicial.  Conclusiones: Los pacientes llevados a la cirugía cardiovascular tienen una insospechada disfunción de los músculos respiratorios que empeora con la cirugía y la hospitalización, que se asocia a un incremento del riesgo de complicaciones respiratorias.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Motivation: To assess the presence of alterations in respiratory muscle strength in patients with a programmed cardiovascular surgery, the impact of the surgery on respiratory muscle function and their relationship with ventilatory alterations during mediate postoperative period. Methods: Prospective observational study. Respiratory function tests (spirometry) and respiratory muscle strength tests (inspiratory: maximum inspiratory pressure, and expiratory: maximum expiratory pressure) were conducted in two moments: immediate preoperative (2 ± 1 days before surgery) and mediate postoperative period (2 ± 1, before being discharged). Respiratory complications included prolonged mechanical ventilation, pulmonary thromboembolism, pneumothorax, hemothorax; pneumonia; pleural effusion; pulmonary edema and atelectases.  Results: 30 adult patients were assessed (n = 30) (ages 62 ± 12). Spirometry performance decreased by 54% in the preoperative period (35% obstructive alteration, 19% non-obstructive) and inspiratory and expiratory weakness was confirmed at 67 and 100% respectively. Respiratory complications were present in 93% (more frequently atelectasis and pleural effusion). Severe postoperative deterioration of maximum inspiratory pressure increased by 10-fold the risk of atelectasis (OR = 10, IC 95% 0.85-117.02; p = 0.067). Upon discharge, ejection fraction of the left ventricle was 29% lower, forced vital capacity -32%, maximum inspiratory pressure -32% and maximum expiratory pressure -32% with regards to baseline values.  Conclusion: Patients undergoing cardiovascular surgery suffer an unsuspected respiratory muscle dysfunction that worsens with surgery and hospitalisation, associated to a increase of the risk of respiratory complications.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cirugía cardiaca]]></kwd>
<kwd lng="es"><![CDATA[Complicaciones]]></kwd>
<kwd lng="es"><![CDATA[Pulmón]]></kwd>
<kwd lng="en"><![CDATA[Cardiac surgery]]></kwd>
<kwd lng="en"><![CDATA[Complications]]></kwd>
<kwd lng="en"><![CDATA[Lung]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Influence of respiratory muscle strength in evolution of patients with heart failure after cardiac surgery]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barreto]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Aragão]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Serra]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Bras Cir Cardiovasc]]></source>
<year>2011</year>
<volume>26</volume>
<page-range>355-63</page-range></nlm-citation>
</ref>
<ref id="B2">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Ventilatory profile of patients undergoing CABG surgery]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morsch]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Leguisamo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Camargo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Coronel]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Mattos]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Bras Cir Cardiovasc]]></source>
<year>2009</year>
<volume>24</volume>
<page-range>180-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[High Prevalence of Respiratory Muscle Weakness in Hospitalized Acute Heart Failure Elderly Patients]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Verissimo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Timenetsky]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Casalaspo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Caserta]]></surname>
<given-names><![CDATA[R.]]></given-names>
</name>
</person-group>
<source><![CDATA[PLoS One]]></source>
<year>2015</year>
<volume>10</volume>
</nlm-citation>
</ref>
<ref id="B4">
<nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martínez-Vázquez]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Torres]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Alteraciones fisiopatológicas y sus repercusiones Rev. Soc. Esp]]></article-title>
<collab>Prevalencia del dolor postoperatorio</collab>
<source><![CDATA[Dolor]]></source>
<year>2000</year>
<volume>7</volume>
<page-range>465-76</page-range></nlm-citation>
</ref>
<ref id="B5">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Respiratory muscle training in patients submitted to coronary arterial bypass graft]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barros]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Granado]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Límaco]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gardenghi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Bras Cir Cardiovasc]]></source>
<year>2010</year>
<volume>25</volume>
<page-range>483-90</page-range></nlm-citation>
</ref>
<ref id="B6">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Preoperative Intensive Inspiratory Muscle Training to Prevent Postoperative Pulmonary Complications in High-Risk Patients Undergoing CABG SurgeryA Randomized Clinical Trial]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hulzebos]]></surname>
<given-names><![CDATA[EH]]></given-names>
</name>
<name>
<surname><![CDATA[Helders]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
<name>
<surname><![CDATA[Favié]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[De Bie]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
<name>
<surname><![CDATA[Brutel de la Riviere]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Van Meeteren]]></surname>
<given-names><![CDATA[NL.]]></given-names>
</name>
</person-group>
<source><![CDATA[JAMA]]></source>
<year>2006</year>
<volume>296</volume>
<numero>15</numero>
<issue>15</issue>
</nlm-citation>
</ref>
<ref id="B7">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Comparison of Incentive Spirometry and Intermittent Positive Pressure Breathing after Coronary Artery Bypass Graft]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Oikkonen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Karjalainen]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Kahara]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Ktiosa]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Schavikin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[Chest]]></source>
<year>1991</year>
<volume>99</volume>
<page-range>60-5</page-range></nlm-citation>
</ref>
<ref id="B8">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Correlação entre força muscular respiratória e otempo de internação pósoperatório]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guedes]]></surname>
<given-names><![CDATA[GP]]></given-names>
</name>
</person-group>
<source><![CDATA[Fisioter Mov]]></source>
<year>2009</year>
<volume>22</volume>
<page-range>605-14</page-range></nlm-citation>
</ref>
<ref id="B9">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Heart failure with preserved ejection fraction induces molecular, mitochondrial, histological, and functional alterations in rat respiratory and limb skeletal muscle]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bowen]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Rolim]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Fischer]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Bakkerud]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Medeiros]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Werner]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Eur J Heart Fail]]></source>
<year>2015</year>
<volume>17</volume>
<page-range>263-72</page-range></nlm-citation>
</ref>
<ref id="B10">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Inspiratory Muscle Training in Patients With Chronic Heart Failure Awaiting Cardiac Transplantation Results of a Pilot Clinical Trial]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cahalin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sernigran]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dec]]></surname>
<given-names><![CDATA[GW]]></given-names>
</name>
</person-group>
<source><![CDATA[Phys Ther]]></source>
<year>1997</year>
<volume>77</volume>
<page-range>830-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Prediction of Postoperative Pulmonary Complications on the Basis of Preoperative Risk Factors in Patients Who Had Undergone Coronary Artery Bypass Graft Surger]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hulzebos]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Van-Meeteren]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[De Bie]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Dagnelie]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Helders]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Phys Ther]]></source>
<year>2003</year>
<volume>83</volume>
<page-range>8-16</page-range></nlm-citation>
</ref>
<ref id="B12">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Avaliação muscular respiratória nas toracotomias e laparotomias superiores eletivas]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bellinetti]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
<name>
<surname><![CDATA[Thomson]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
</person-group>
<source><![CDATA[J Bras Pneumol]]></source>
<year>2006</year>
<volume>32</volume>
<page-range>99-105</page-range></nlm-citation>
</ref>
<ref id="B13">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Preoperative respiratory muscle dysfunction is a predictor of prolonged invasive mechanical ventilation in cardiorespiratory complications after heart valve surgery]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mendes]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Arruda]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Xavier]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<source><![CDATA[Eur J Cardiothorac Surg]]></source>
<year>2011</year>
<volume>39</volume>
<page-range>662-6</page-range></nlm-citation>
</ref>
<ref id="B14">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Effects of an Inspiratory Muscle Rehabilitation Program in the Postoperative Period of Cardiac Surgery]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Barboza]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<source><![CDATA[Arq Bras Cardiol]]></source>
<year>2009</year>
<volume>92</volume>
<page-range>275-82</page-range></nlm-citation>
</ref>
<ref id="B15">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Assessment in Thoracic Surgery Patients With Special Reference to Postoperative Pulmonary Complications]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Nomori]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Kobayashi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Fuyun]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Morinaga]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Yashima]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<source><![CDATA[Chest]]></source>
<year>1994</year>
<volume>105</volume>
<page-range>1782-8</page-range></nlm-citation>
</ref>
<ref id="B16">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Complicaciones del dolor postoperatorio Rev Soc. Esp]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Muñoz-Blanco]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Salmerón]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Santiago]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Marcote]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Dolor]]></source>
<year>2001</year>
<volume>8</volume>
<page-range>194-211</page-range></nlm-citation>
</ref>
<ref id="B17">
<nlm-citation citation-type="">
<collab>Manual SEPAR de Procedimientos</collab>
<source><![CDATA[Procedimientos de evaluacion de la función pulmonar]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B18">
<nlm-citation citation-type="">
<collab>The Society of Thoracy Surgeons</collab>
<source><![CDATA[Adult Cardiac Surgery Database, v2.61 Training Manual]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B19">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[The assessment of maximal respiratory mouth pressures in adults]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Evans]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Whitelaw]]></surname>
<given-names><![CDATA[WA]]></given-names>
</name>
</person-group>
<source><![CDATA[Respir Care]]></source>
<year>2009</year>
<volume>54</volume>
<page-range>1348-59</page-range></nlm-citation>
</ref>
<ref id="B20">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Maximal inspiratory mouth pressures (PIMAX) in healthy subject what is the lower limit of normal]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hautmann]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Hefele]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Schotten]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Huber]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<source><![CDATA[Respir Med]]></source>
<year>2000</year>
<volume>94</volume>
<page-range>689-93</page-range></nlm-citation>
</ref>
<ref id="B21">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Valores de referencia para población caucásica mediterránea]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morales]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Sanchis]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Cordero]]></surname>
<given-names><![CDATA[P-J]]></given-names>
</name>
<name>
<surname><![CDATA[Dies]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<source><![CDATA[Arch Bronconeumol]]></source>
<year>1997</year>
<volume>33</volume>
<page-range>213-9</page-range></nlm-citation>
</ref>
<ref id="B22">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Respiratory Muscle Dysfunction in Congestive Heart Failure Clinical Correlation and Prognostic Significance]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Meyer]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Borst]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zugck]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Kirschke]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Schellberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kübler]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<source><![CDATA[Circulation]]></source>
<year>2001</year>
<volume>103</volume>
<page-range>2153-8</page-range></nlm-citation>
</ref>
<ref id="B23">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Respiratory physiotherapy and its application in preoperative period of cardiac surgery]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vasques]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Trevizan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Rev Bras Cir Cardiovasc]]></source>
<year>2011</year>
<volume>26</volume>
<page-range>647-52</page-range></nlm-citation>
</ref>
<ref id="B24">
<nlm-citation citation-type="journal">
<article-title xml:lang=""><![CDATA[Inspiratory muscle training in patients with heart failure and inspiratory muscle weakness: a randomized trial.]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dall'Ago]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Chiappa]]></surname>
<given-names><![CDATA[GR]]></given-names>
</name>
<name>
<surname><![CDATA[Guths]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Stein]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
</person-group>
<source><![CDATA[J Am Coll Cardiol]]></source>
<year>2006</year>
<volume>47</volume>
<page-range>757-63</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
