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内在有氧能力和呼吸机诱发的膈肌功能障碍的作用。

Role of intrinsic aerobic capacity and ventilator-induced diaphragm dysfunction.

作者信息

Sollanek Kurt J, Smuder Ashley J, Wiggs Michael P, Morton Aaron B, Koch Lauren G, Britton Steven L, Powers Scott K

机构信息

Department of Applied Physiology and Kinesiology, Center for Exercise Science, University of Florida, Gainesville, Florida; and.

Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.

出版信息

J Appl Physiol (1985). 2015 Apr 1;118(7):849-57. doi: 10.1152/japplphysiol.00797.2014. Epub 2015 Jan 8.

Abstract

Prolonged mechanical ventilation (MV) leads to rapid diaphragmatic atrophy and contractile dysfunction, which is collectively termed "ventilator-induced diaphragm dysfunction" (VIDD). Interestingly, endurance exercise training prior to MV has been shown to protect against VIDD. Further, recent evidence reveals that sedentary animals selectively bred to possess a high aerobic capacity possess a similar skeletal muscle phenotype to muscles from endurance trained animals. Therefore, we tested the hypothesis that animals with a high intrinsic aerobic capacity would naturally be afforded protection against VIDD. To this end, animals were selectively bred over 33 generations to create two divergent strains, differing in aerobic capacity: high-capacity runners (HCR) and low-capacity runners (LCR). Both groups of animals were subjected to 12 h of MV and compared with nonventilated control animals within the same strains. As expected, contrasted to LCR animals, the diaphragm muscle from the HCR animals contained higher levels of oxidative enzymes (e.g., citrate synthase) and antioxidant enzymes (e.g., superoxide dismutase and catalase). Nonetheless, compared with nonventilated controls, prolonged MV resulted in significant diaphragmatic atrophy and impaired diaphragm contractile function in both the HCR and LCR animals, and the magnitude of VIDD did not differ between strains. In conclusion, these data demonstrate that possession of a high intrinsic aerobic capacity alone does not afford protection against VIDD. Importantly, these results suggest that endurance exercise training differentially alters the diaphragm phenotype to resist VIDD. Interestingly, levels of heat shock protein 72 did not differ between strains, thus potentially representing an important area of difference between animals with intrinsically high aerobic capacity and exercise-trained animals.

摘要

长时间机械通气(MV)会导致膈肌迅速萎缩和收缩功能障碍,这被统称为“呼吸机诱发的膈肌功能障碍”(VIDD)。有趣的是,研究表明在进行机械通气之前进行耐力运动训练可预防VIDD。此外,最近的证据显示,经选择性培育具有高有氧能力的久坐不动动物,其骨骼肌表型与耐力训练动物的肌肉相似。因此,我们检验了以下假设:具有高内在有氧能力的动物自然会受到VIDD的保护。为此,动物经过33代的选择性培育,产生了两个有氧能力不同的品系:高能力跑步者(HCR)和低能力跑步者(LCR)。两组动物均接受12小时的机械通气,并与同一品系中未通气的对照动物进行比较。正如预期的那样,与LCR动物相比,HCR动物的膈肌含有更高水平的氧化酶(如柠檬酸合酶)和抗氧化酶(如超氧化物歧化酶和过氧化氢酶)。尽管如此,与未通气的对照组相比,长时间的机械通气导致HCR和LCR动物均出现明显的膈肌萎缩和膈肌收缩功能受损,且VIDD的严重程度在两个品系之间并无差异。总之,这些数据表明,仅拥有高内在有氧能力并不能预防VIDD。重要的是,这些结果表明耐力运动训练会以不同方式改变膈肌表型以抵抗VIDD。有趣的是,热休克蛋白72的水平在两个品系之间并无差异,因此这可能代表了具有高内在有氧能力的动物与运动训练动物之间的一个重要差异领域。

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