Romaniuk J R, Supinski G S, DiMarco A F
Department of Medicine, MetroHealth Medical Center, Cleveland, Ohio 44109-1998.
J Appl Physiol (1985). 1993 Jul;75(1):63-9. doi: 10.1152/jappl.1993.75.1.63.
Recent studies suggest that chest wall reflexes may have a role in modulating diaphragm activation. The purpose of this study was to more closely examine this issue by assessing the diaphragmatic motor response to airway occlusion. Studies were performed in vagotomized mongrel dogs anesthetized with pentobarbital sodium. Diaphragmatic electromyogram (EMG) and phrenic neurogram (ENG) responses to airway occlusion were evaluated at different precontractile respiratory muscle lengths, achieved by passive inflation and deflation with a volume syringe during the preceding expiration. Lung volume was expressed as the corresponding change in airway pressure. At functional residual capacity, deflation (-5 cmH2O), and large inflation (+25 cmH2O), phrenic ENG during occlusion was 90 +/- 2 (SE), 84 +/- 5, and 86 +/- 3% of the preceding control breaths, respectively (n = 9). Qualitatively similar, but somewhat more pronounced, responses were observed on diaphragmatic EMG. With small lung inflations, the degree of reduction of phrenic ENG with airway occlusion was less. Consequently, the relationship between airway pressure and degree of inhibition was best described as a reverse parabola with the maximum at approximately +10-15 cmH2O. Responses were not significantly affected by bilateral cervical phrenicotomy. Complete section of the spinal cord at the high thoracic level (T1-T2) abolished the observed reduction in phrenic ENG in response to airway occlusion. Our results demonstrate 1) the existence of nonvagal nonphrenic reflex control of diaphragm activation most likely secondary to activation of intercostal afferents and 2) that the magnitude of this reflex is highly dependent on factors related to lung volume.
近期研究表明,胸壁反射可能在调节膈肌激活方面发挥作用。本研究的目的是通过评估气道阻塞时的膈肌运动反应来更深入地探讨这一问题。研究在戊巴比妥钠麻醉的迷走神经切断杂种犬身上进行。在先前呼气期间,通过容积注射器进行被动充气和放气,使呼吸肌在不同的预收缩长度下,评估气道阻塞时的膈肌肌电图(EMG)和膈神经电图(ENG)反应。肺容积以气道压力的相应变化表示。在功能残气量、放气(-5 cmH₂O)和大幅度充气(+25 cmH₂O)时,阻塞期间的膈神经ENG分别为先前对照呼吸的90±2(SE)、84±5和86±3%(n = 9)。在膈肌EMG上观察到定性相似但更为明显的反应。在肺轻度充气时,气道阻塞时膈神经ENG的降低程度较小。因此气道压力与抑制程度之间的关系最好描述为一条反向抛物线,最大值约为+10 - 15 cmH₂O。双侧颈膈神经切断术对反应无显著影响。在胸段高位(T1 - T2)完全切断脊髓消除了观察到的气道阻塞时膈神经ENG的降低。我们的结果表明:1)膈肌激活存在非迷走神经非膈神经反射控制,最可能继发于肋间传入神经的激活;2)该反射的强度高度依赖于与肺容积相关的因素。