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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