Osborne S, Road J D
Department of Medicine (Respiratory), University of British Columbia, Vancouver, Canada.
Respir Physiol. 1995 Mar;99(3):321-30. doi: 10.1016/0034-5687(94)00109-d.
To determine whether decreases in neural activation and/or neuromuscular transmission to the diaphragm contribute to ventilatory failure observed during inspiratory resistive loaded breathing, peak integrated activity of the intact phrenic nerve (ENGdi) and costal diaphragm (EMGdi), transdiaphragmatic pressure swings (Pdi) and evoked diaphragm compound action potentials (M-wave) were measured in anesthetized rabbits subjected to inspiratory resistive loads of varying intensities and duration breathing supplemental oxygen. Sustainable loads were studied for 4 h. Severe loads were applied in increments and studied for 50 min each. Loading resulted in parallel increases in ENGdi, EMGdi and Pdi that stabilized within 20 min. With severe loading, peak inspiratory pressure (Pao = -55 +/- 4 cm H2O) was maintained for 30 min after which there was a significant drop in inspiratory pressure (task failure). Despite hypoventilation and profound changes in blood gases, both activation (ENGdi) and neuromuscular transmission (ENGdi/EMGdi ratio or M-wave) were maintained throughout all loads even at task failure when a critical level of PaO2 (27 +/- 1 mm Hg) was reached. We conclude that neural activation and neuromuscular transmission to the diaphragm do not fail during inspiratory resistive breathing and discuss our findings in terms of current concepts of diaphragm fatigue and control of breathing in this model.
为了确定在吸气阻力负荷呼吸过程中观察到的通气衰竭是否由膈神经激活和/或膈神经肌肉传递减少所致,在吸入补充氧气的情况下,对接受不同强度和持续时间吸气阻力负荷的麻醉兔测量完整膈神经(ENGdi)和肋膈膜(EMGdi)的峰值综合活动、跨膈压波动(Pdi)以及诱发的膈复合动作电位(M波)。对持续负荷进行4小时研究。对重度负荷以递增方式施加,并每次研究50分钟。负荷导致ENGdi、EMGdi和Pdi平行增加,并在20分钟内稳定下来。在重度负荷下,吸气峰值压力(Pao = -55 +/- 4 cm H2O)维持30分钟,之后吸气压力显著下降(任务失败)。尽管存在通气不足和血气的深刻变化,但即使在任务失败达到临界PaO2水平(27 +/- 1 mmHg)时,在所有负荷过程中激活(ENGdi)和神经肌肉传递(ENGdi/EMGdi比值或M波)均得以维持。我们得出结论,在吸气阻力呼吸过程中膈神经激活和神经肌肉传递并未失败,并根据该模型中膈疲劳和呼吸控制的当前概念讨论了我们的研究结果。