Leevers A M, Road J D
Department of Medicine, University of British Columbia, Vancouver, Canada.
Respir Physiol. 1991 Jul;85(1):29-40. doi: 10.1016/0034-5687(91)90004-3.
In an earlier study (Road and Leevers (1988), J. Appl. Physiol. 65: 2283-2389), the application of continuous positive airway pressure (CPAP) produced a marked reduction in diaphragm initial length (LFRC) and tidal diaphragmatic shortening (%LFRC), tidal volume (VT) and transdiaphragmatic pressure swings (delta Pdi) in supine dogs after vagotomy. We postulated that the reduced diaphragmatic shortening was mainly a result of the decrease in diaphragm LFRC but an increase in afterload could not be excluded. In this study, we attempted to define the role of these two mechanisms during postural change. Eight, pentobarbital-anaesthetized, vagotomized dogs were studied in the supine position during CPAP and during postural change (tilting towards upright). As before, CPAP produced a prompt reduction in diaphragm LFRC and tidal %LFRC, VT and delta Pdi. Tilting produced similar decreases in crural diaphragm LFRC (23% from control values) as the weight of the abdominal contents was removed, but less decrease in costal LFRC (17% during CPAP compared to 10% during tilting). A given reduction in crural diaphragm initial length (15%) resulted in less tidal shortening during tilting compared to CPAP, whereas costal diaphragm shortening was similar at a given reduction in initial length (10%). Both CPAP and tilting reduced tidal volumes (47.8 +/- 5.1 and 56.5 +/- 3.1% of control), however, delta Pdi decreased less during tilting (20%) than CPAP (47%). There was no significant change in the level of diaphragmatic EMG with either CPAP or tilting.(ABSTRACT TRUNCATED AT 250 WORDS)
在一项早期研究中(罗德和利弗斯(1988年),《应用生理学杂志》65卷:2283 - 2389页),在迷走神经切断后的仰卧位犬中,应用持续气道正压通气(CPAP)使膈肌初始长度(LFRC)、潮气量时膈肌缩短百分比(%LFRC)、潮气量(VT)和跨膈压摆动(δPdi)显著降低。我们推测膈肌缩短减少主要是膈肌LFRC降低的结果,但不能排除后负荷增加的影响。在本研究中,我们试图确定这两种机制在体位改变过程中的作用。对8只戊巴比妥麻醉、迷走神经切断的犬在仰卧位时进行CPAP以及体位改变(向直立倾斜)时进行研究。如前所述,CPAP使膈肌LFRC、潮气量%LFRC、VT和δPdi迅速降低。倾斜导致膈脚膈肌LFRC(比对照值降低23%)出现类似下降,这是由于腹部内容物重量移除,但肋部LFRC下降较少(CPAP期间为17%,倾斜期间为10%)。与CPAP相比,在倾斜时给定的膈脚膈肌初始长度减少(15%)导致潮气量缩短较少,而在初始长度给定减少(10%)时,肋部膈肌缩短相似。CPAP和倾斜均使潮气量减少(分别为对照值的47.8±5.1%和56.5±3.1%),然而,倾斜时δPdi降低幅度(20%)小于CPAP(47%)。CPAP或倾斜时膈肌肌电图水平均无显著变化。(摘要截断于250字)