Krayer S, Decramer M, Vettermann J, Ritman E L, Rehder K
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota 55905.
J Appl Physiol (1985). 1988 Nov;65(5):2213-20. doi: 10.1152/jappl.1988.65.5.2213.
We employed high-speed multisliced X-ray-computed tomography to determine the relative volume contributions of rib cage (delta Vrc) and diaphragmatic motion (delta Vdi) to tidal volume (VT) during spontaneous breathing in 6 anesthetized dogs lying supine. Mean values were 40 +/- 6% (SE) for delta Vrc and 62 +/- 8% of VT for delta Vdi. The difference between VT and changes in thoracic cavity volume was taken to represent a change in thoracic blood volume (2 +/- 3% of VT). To estimate how much of delta Vrc was caused by diaphragmatic contraction and how much of delta Vdi was caused by rib cage motion, delta Vrc and delta Vdi were determined during bilateral stimulation of the C5-C6 phrenic nerve roots in the apneic dog and again during spontaneous breathing after phrenicotomy. Thoracic cavity volume (Vth) measured during hypocapnic apnea was consistently larger than Vth at end expiration, suggesting that relaxation of expiratory muscles contributed significantly to both delta Vrc and delta Vdi during spontaneous inspiration. Phrenic nerve stimulation did not contribute to delta Vrc, suggesting that diaphragmatic contraction had no net expanding action on the rib cage above the zone of apposition. Spontaneous breathing after phrenicotomy resulted in small and inconsistent diaphragmatic displacement (8 +/- 4% of VT). We conclude that the diaphragm does not drive the rib cage to inflate the lungs and that rib cage motion does not significantly affect diaphragmatic position during spontaneous breathing in anesthetized dogs lying supine.
我们采用高速多层X射线计算机断层扫描技术,以确定6只仰卧位麻醉犬在自主呼吸过程中,胸廓(ΔVrc)和膈肌运动(ΔVdi)对潮气量(VT)的相对容积贡献。ΔVrc的平均值为40±6%(标准误),ΔVdi为VT的62±8%。将VT与胸腔容积变化之间的差值视为胸腔血容量的变化(占VT的2±3%)。为了估计ΔVrc中有多少是由膈肌收缩引起的,以及ΔVdi中有多少是由胸廓运动引起的,在呼吸暂停的犬双侧刺激C5 - C6膈神经根时测定ΔVrc和ΔVdi,并在膈神经切断术后自主呼吸期间再次测定。低碳酸血症呼吸暂停期间测得的胸腔容积(Vth)始终大于呼气末的Vth,这表明呼气肌的舒张对自主吸气期间的ΔVrc和ΔVdi均有显著贡献。膈神经刺激对ΔVrc没有影响,这表明膈肌收缩对附着区上方的胸廓没有净扩张作用。膈神经切断术后的自主呼吸导致膈肌位移较小且不一致(占VT的8±4%)。我们得出结论,在仰卧位麻醉犬的自主呼吸过程中,膈肌不会驱动胸廓扩张肺部,胸廓运动也不会显著影响膈肌位置。