Hershenson M B, Stark A R, Mead J
Department of Anesthesia, Harvard Medical School, Boston, Massachusetts.
Am Rev Respir Dis. 1989 May;139(5):1207-12. doi: 10.1164/ajrccm/139.5.1207.
To determine whether the rib cage muscles actively contribute to tidal volume change in infancy, we measured tidal volume (VT), using a pneumotachograph, respiratory gastric pressure swings (Pga), using a liquid-filled gastric catheter, and rib cage and abdominal volume, using respiratory inductive plethysmography in 15 newborns, both before and during 2% CO2-induced hyperventilation. Active rib cage expansion produced by phasic contraction of the inspiratory muscles of the rib cage should reduce respiratory abdominal pressure fluctuations by moving the anterior abdominal wall outward and cephalad, thereby having an expanding influence on the abdominal cavity. During quiet sleep (n = 13), CO2-induced hyperventilation was associated with significant increases in VT, Pga, rib cage volume (Vrc), and abdominal volume (Vab). Increments in Pga were small relative to VT, as shown by an increase in the slope of the VT versus Pga respiratory loop (VT/Pga) in all subjects (p less than 0.001, paired t test). CO2 breathing was associated with an increase in the contribution of the rib cage compartment to total volume change (Vrc/Vrc + Vab) in all infants studied (p less than 0.001, paired t test), and the total volume response to hyperventilation was more strongly related to changes in rib cage volume (slope = 0.62, r = 0.90) than to abdominal volume (slope = 0.31, r = 0.60). During REM sleep (n = 6), mean VT/Pga did not change significantly, and the rib cage contribution to tidal breathing decreased in three of six infants.(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定胸廓肌肉是否在婴儿期对潮气量变化有积极作用,我们在15名新生儿中,于吸入2%二氧化碳诱发过度通气之前及期间,使用呼吸流速仪测量潮气量(VT),使用充液胃导管测量呼吸时胃内压力波动(Pga),并使用呼吸感应体积描记法测量胸廓和腹部容积。胸廓吸气肌的阶段性收缩所产生的胸廓主动扩张,应通过将前腹壁向外和向上移动来减少呼吸时腹部压力波动,从而对腹腔产生扩张作用。在安静睡眠状态下(n = 13),二氧化碳诱发的过度通气与VT、Pga、胸廓容积(Vrc)和腹部容积(Vab)的显著增加相关。与VT相比,Pga的增加幅度较小,所有受试者的VT与Pga呼吸环斜率(VT/Pga)均增加(p < 0.001,配对t检验)。在所有研究的婴儿中,二氧化碳呼吸与胸廓部分对总体积变化的贡献增加相关(Vrc/Vrc + Vab)(p < 0.001,配对t检验),并且过度通气引起的总体积反应与胸廓容积变化的相关性更强(斜率 = 0.62,r = 0.90),而与腹部容积变化的相关性较弱(斜率 = 0.31,r = 0.60)。在快速眼动睡眠状态下(n = 6),平均VT/Pga无显著变化,并且在6名婴儿中有3名婴儿胸廓对潮式呼吸的贡献减少。(摘要截短于250字)