Mattila S, Mattila I, Viljanen B, Viljanen A
Scand J Thorac Cardiovasc Surg. 1987;21(1):15-20. doi: 10.3109/14017438709116913.
In combined heart-lung transplantation the afferent nerve pathways inevitably are transsected. In previous studies with en bloc heart-lung transplantation in dogs, we found altered regulation of breathing-abolition of Hering-Breuer reflex and response to hypercapnia inhalation stimulus consisting of augmented tidal volume with no change in respiratory rate-shortly after the operation. The long-term effects of pulmonary denervation on breathing regulation were now studied in dogs after staged bilateral pulmonary autotransplantation. Mechanical and electrical activities of the respiratory muscles were recorded during spontaneous breathing and after deflation and inflation with varying volumes of air. Five months postoperatively the duration of the respiratory cycle increased 2.5 times on inflation with 600 ml of air and occlusion of the airways, compared with tenfold prolongation in intact control dogs, indicating a partial return of the Hering-Breuer reflex after the autotransplantation. The duration of the EMG bursts in respiratory muscles increased in intact dogs and in those with bilateral lung autotransplants. In impulse frequency the response to stretching was less evident after autotransplantation. The mechanism mediating reappearance of Hering-Breuer reflex warrants further study.
在心肺联合移植中，传入神经通路不可避免地会被切断。在之前对狗进行整块心肺移植的研究中，我们发现术后不久呼吸调节发生改变——赫林-布雷尔反射消失，对吸入高碳酸血症刺激的反应表现为潮气量增加而呼吸频率不变。现在，我们在狗进行分期双侧肺自体移植后研究了肺去神经对呼吸调节的长期影响。在自主呼吸期间以及用不同体积的空气进行放气和充气后，记录呼吸肌的机械和电活动。术后五个月，与完整对照狗延长十倍相比，用600毫升空气充气并阻塞气道时，呼吸周期的持续时间增加了2.5倍，这表明自体移植后赫林-布雷尔反射部分恢复。完整狗和双侧肺自体移植狗的呼吸肌肌电图爆发持续时间均增加。在冲动频率方面，自体移植后对拉伸的反应不太明显。介导赫林-布雷尔反射重新出现的机制值得进一步研究。
