Sadoul N, Bazzy A R, Akabas S R, Haddad G G
J Appl Physiol (1985). 1985 Sep;59(3):969-78. doi: 10.1152/jappl.1985.59.3.969.
To study the changes in ventilation induced by inspiratory flow-resistive (IFR) loads, we applied moderate and severe IFR loads in chronically instrumented and awake sheep. We measured inspired minute ventilation (VI), ventilatory pattern [inspiratory time (TI), expiratory time (TE), respiratory cycle time (TT), tidal volume (VT), mean inspiratory flow (VT/TI), and respiratory duty cycle (TI/TT)], transdiaphragmatic pressure (Pdi), functional residual capacity (FRC), blood gas tensions, and recorded diaphragmatic electromyogram. With both moderate and severe loads, Pdi, TI, and TI/TT increased, TE, TT, VT, VT/TI, and VI decreased, and hypercapnia ensued. FRC did not change significantly with moderate loads but decreased by 30-40% with severe loads. With severe loads, arterial PCO2 (PaCO2) stabilized at approximately 60 Torr within 10-15 min and rose further to levels exceeding 80 Torr when Pdi dropped. This was associated with a lengthening in TE and a decrease in breathing frequency, VI, and TI/TT. We conclude that 1) timing and volume responses to IFR loads are not sufficient to prevent alveolar hypoventilation, 2) with severe loads the considerable increase in Pdi, TI/TT, and PaCO2 may reduce respiratory muscle endurance, and 3) the changes in ventilation associated with neuromuscular fatigue occur after the drop in Pdi. We believe that these ventilatory changes are dictated by the mechanical capability of the respiratory muscles or induced by a decrease in central neural output to these muscles or both.
为研究吸气气流阻力(IFR)负荷引起的通气变化,我们对长期植入仪器且清醒的绵羊施加中度和重度IFR负荷。我们测量了吸入分钟通气量(VI)、通气模式[吸气时间(TI)、呼气时间(TE)、呼吸周期时间(TT)、潮气量(VT)、平均吸气流量(VT/TI)和呼吸占空比(TI/TT)]、跨膈压(Pdi)、功能残气量(FRC)、血气张力,并记录膈肌肌电图。在中度和重度负荷下,Pdi、TI和TI/TT均增加,TE、TT、VT、VT/TI和VI均降低,随后出现高碳酸血症。FRC在中度负荷下无显著变化,但在重度负荷下降低了30 - 40%。在重度负荷下,动脉PCO2(PaCO2)在10 - 15分钟内稳定在约60 Torr,当Pdi下降时进一步升至超过80 Torr的水平。这与TE延长以及呼吸频率、VI和TI/TT降低有关。我们得出结论:1)对IFR负荷的时间和容量反应不足以防止肺泡通气不足;2)在重度负荷下,Pdi、TI/TT和PaCO2的显著增加可能会降低呼吸肌耐力;3)与神经肌肉疲劳相关的通气变化发生在Pdi下降之后。我们认为这些通气变化是由呼吸肌的机械能力决定的,或者是由中枢神经向这些肌肉的输出减少引起的,或者两者兼而有之。