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Pharmacological treatment of respiratory insufficiency.

The respiratory muscles, as any other skeletal muscle can fatigue. Respiratory muscle fatigue has been shown to play an important role in the pathogenesis of dyspnea and respiratory failure. Treatment of this respiratory muscle dysfunction appears therefore to be clinically important in patients with respiratory diseases. The respiratory muscles and particularly the diaphragm present some particularities among the skeletal muscles. The diaphragm excitation-contraction coupling processes and blood flow appear to be closer to the myocardium than to the peripheral skeletal muscles. Pharmacological agents that enhance respiratory muscle function by acting at these two levels may therefore be clinically useful. This review deals essentially with respiratory muscle dysfunction and its pharmacological approach.