Strohl K P, Gottfried S B, Van de Graaff W, Wood R E, Fouke J M
Respir Physiol. 1986 Feb;63(2):161-75. doi: 10.1016/0034-5687(86)90111-8.
The purpose of this study was to determine whether pharmacologic interventions which increase respiratory drive could also reduce flow resistance in the upper airway. Studies were performed in twelve anesthetized supine dogs. In six animals breathing spontaneously through the intact upper airway, intravenous administration of respiratory stimulants (sodium cyanide and nicotine) produced a dose-related decrease in upper airway. In nine animals, upper airway resistance was measured across the isolated upper airway. The stimulants produced a dose-related decrease in upper airway resistance. In both preparations inspiratory resistance fell at lower doses than expiratory resistance. Eventually a dose could be given which resulted in comparable, minimal values of resistance during both inspiration and expiration. Mechanisms for changes in resistance were clarified using lateral radiographs of the neck and transbronchoscopic views of the upper airway. Pharmacologic challenge resulted in a change in the route of airflow (from nose only to nose-and-mouth breathing) as well as a change in caliber of the airway at the level of the naso-pharynx and hyoid apparatus. In anesthetized dogs, respiratory stimulants will decrease upper airway resistance by increasing activation of upper airway muscles which may enlarge the airway, change the route of flow, and thus overcoming collapsing forces produced by increased chest wall muscle activation.
本研究的目的是确定增加呼吸驱动力的药物干预措施是否也能降低上呼吸道的气流阻力。研究在12只麻醉后仰卧的犬身上进行。在6只通过完整上呼吸道自主呼吸的动物中,静脉注射呼吸兴奋剂(氰化钠和尼古丁)使上呼吸道阻力呈剂量依赖性降低。在9只动物中,测量了孤立上呼吸道的上呼吸道阻力。兴奋剂使上呼吸道阻力呈剂量依赖性降低。在两种准备状态下,吸气阻力在比呼气阻力更低的剂量时下降。最终可以给予一个剂量,使得吸气和呼气时的阻力值相当且最小。使用颈部侧位X线片和上呼吸道的经支气管镜视图来阐明阻力变化的机制。药物激发导致气流途径改变(从仅经鼻呼吸变为鼻口呼吸)以及鼻咽部和舌骨装置水平气道口径的改变。在麻醉犬中,呼吸兴奋剂将通过增加上呼吸道肌肉的激活来降低上呼吸道阻力,这可能会扩大气道、改变气流途径,从而克服胸壁肌肉激活增加所产生的塌陷力。