Johnston B M, Gunn T R, Gluckman P D
Department of Paediatrics, School of Medicine, University of Auckland, New Zealand.
Pediatr Res. 1988 Mar;23(3):257-61. doi: 10.1203/00006450-198803000-00005.
Stimulation of cutaneous thermoreceptors may be an important factor in the initiation of continuous breathing at birth. Maintenance of a patent airway is also important in the continuation of effective ventilation after birth, but whereas in the adult the principal pharyngeal dilator is the genioglossus muscle, in the fetus genioglossus phasic activity is not synchronous with that of the fetal diaphragm. To ascertain whether a cold stimulus that initiates continuous breathing would also induce synchronized inspiratory activity in the upper airway muscles of the fetus, we have cooled fetal lambs in utero and examined the response of the genioglossus and alae nasi muscles in relation to diaphragm activity. Deep regular breathing as recorded by diaphragmatic activity and tracheal pressure started within 1-102 s after cooling commenced and coordinated inspiratory activity was seen in the alae nasi within 2-356 s. Genioglossus activity became synchronized with that of the diaphragm within 11-356 s. Cooling was continued for 4 h but although in one fetus continuous breathing with associated inspiratory activity in the genioglossus and alae nasi muscles lasted throughout the 4-h period, in the others continuous breathing was not sustained and adaptation to the cold stimulus occurred after periods ranging from 27-218 min. The relationship between breathing, upper airway muscle activity, and sleep state passed through one or more different phases, including breathing through high voltage electrocortical activity, before the normal fetal pattern of episodic breathing restricted to the low voltage electrocortical state resumed.(ABSTRACT TRUNCATED AT 250 WORDS)
刺激皮肤温度感受器可能是出生时启动持续呼吸的一个重要因素。出生后维持气道通畅对于有效通气的持续也很重要,然而,在成年人中,主要的咽部扩张肌是颏舌肌,而在胎儿中,颏舌肌的阶段性活动与胎儿膈肌的活动不同步。为了确定启动持续呼吸的冷刺激是否也会诱导胎儿上呼吸道肌肉的同步吸气活动,我们在子宫内冷却了胎羊,并检查了颏舌肌和鼻翼肌相对于膈肌活动的反应。冷却开始后1 - 102秒内,通过膈肌活动和气管压力记录到深度规律呼吸开始,2 - 356秒内鼻翼出现协调的吸气活动。颏舌肌活动在11 - 356秒内与膈肌活动同步。冷却持续4小时,尽管在一只胎儿中,颏舌肌和鼻翼肌相关吸气活动的持续呼吸在整个4小时内持续存在,但在其他胎儿中,持续呼吸并未持续,在27 - 218分钟不等的时间段后出现了对冷刺激的适应。在正常的胎儿间歇性呼吸模式恢复到仅限于低电压皮质状态之前,呼吸、上呼吸道肌肉活动和睡眠状态之间的关系经历了一个或多个不同阶段,包括通过高电压皮质活动进行呼吸。(摘要截短于250字)