Aldrich T K
Department of Medicine, Montefiore Medical Center, Bronx, New York 10467.
Lung. 1988;166(4):233-41. doi: 10.1007/BF02714052.
This study evaluates the importance of central fatigue of the diaphragm in rabbits subjected to inspiratory muscle resistive loading (IRL). Ten rabbits were subjected to constant IRL while unanesthetized and breathing supplemental oxygen. During 10-20 minutes of spontaneous breathing against IRL, there were no significant changes in arterial oxygen saturation or in diaphragm contractility, measured by the quasi-static transdiaphragmatic pressure response to a 0.3-sec train of 100 Hz supramaximal phrenic nerve stimuli. After an initial decrease due to application of the load, the minute ventilation decreased further, by an average of 15%, while arterial pCO2 increased to an average of 59 mmHg (p less than 0.05). The normalized diaphragm pressure-time index initially increased from 0.02 to 0.18 during IRL, then decreased an average of 29% (p less than 0.05). These results show that severe IRL causes a decrease in the level of diaphragmatic effort over time despite increased chemical drive and despite a preserved ability of the muscle to respond to phrenic nerve stimuli. This adaptation may help to prevent peripheral diaphragm fatigue.
本研究评估了吸气肌阻力负荷(IRL)对兔膈肌中枢性疲劳的影响。十只兔在未麻醉且呼吸补充氧气的情况下接受持续IRL。在对抗IRL进行10 - 20分钟自主呼吸期间,通过对100 Hz超最大膈神经刺激的0.3秒串刺激所产生的准静态跨膈压反应来测量,动脉血氧饱和度或膈肌收缩力均无显著变化。在施加负荷后最初有所下降,分钟通气量进一步下降,平均下降15%,而动脉血二氧化碳分压升高至平均59 mmHg(p < 0.05)。标准化膈肌压力 - 时间指数在IRL期间最初从0.02增加到0.18,然后平均下降29%(p < 0.05)。这些结果表明,尽管化学驱动增加且肌肉对膈神经刺激的反应能力保持,但严重的IRL会导致随着时间推移膈肌用力水平下降。这种适应性变化可能有助于防止外周膈肌疲劳。