PubMed Health⌕ Search

Biomedical subjects

E A Stuth

Publications and source records attributed to E A Stuth.

21 records · Page 2Linked to original sources

Dose-dependent effects of halothane on the carbon dioxide responses of expiratory and inspiratory bulbospinal neurons and the phrenic nerve activities in dogs.

BACKGROUND: Expiratory bulbospinal and inspiratory bulbospinal neurons in the ventral respiratory group provide drive for thoracoabdominal expiratory and phrenic and thoracic inspiratory motor neurons. Potent inhalational agents such as halothane may have differential effects on inspiratory and expiratory neurons, but detailed studies comparing neurons at a homologous level are lacking. METHODS: The dose-dependent effects of anesthesia with 1.0-2.5 minimum alveolar concentration halothane on the CO2 responses of single expiratory and inspiratory bulbospinal neurons of the ventral respiratory group and on phrenic neural activities were studied in nonpremedicated, anesthetized, paralyzed, vagotomized dogs. Hyperventilation with O2 and the addition of CO2-O2 mixtures were used to produce low, medium, and high steady-state levels of central CO2 drive. RESULTS: Peak neuron discharge frequency decreased progressively with increasing halothane dose at all levels of CO2 drive for both types of neurons. The sensitivities of inspiratory and expiratory bulbospinal neuronal activities to halothane were not significantly different from one another, whereas the sensitivity to halothane of the peak phrenic activity was markedly greater than those of the neurons. Increasing halothane dose caused a downward, predominantly parallel shift of the CO2 response curves. Phrenic nerve activity also showed a decrease in slope of the CO2 response. CONCLUSIONS: The activities of respiratory premotor neurons are less depressed by increasing doses of halothane than is phrenic nerve activity. The greater depression of phrenic activity may result from additional anesthetic actions on the efferent motor pathways, resulting in decreased descending synaptic inputs to phrenic motor neurons.

Animals↗

Dose-dependent effects of isoflurane on the CO2 responses of expiratory medullary neurons and the phrenic nerve activities in dogs.

Expiratory bulbospinal neurons (EBS) neurons in the region of the nucleus retroambigualis provide a major source of drive for thoracic and abdominal expiratory motoneurons. These studies examined the dose-dependent effects of isoflurane anesthesia from 0.5-2.5 minimum alveolar concentration (MAC) on the CO2 responses of extracellularly recorded single EBS neurons and phrenic neural activities in unpremedicated, anesthetized, paralyzed, vagotomized dogs. Hyperventilation with O2 and the addition of CO2-O2 mixtures were used to produce three steady-state levels of central CO2 drive: low, medium, and high with corresponding mean PaCO2 values of 29, 45, and 67 mmHg. Plots of peak expiratory neuron discharge frequency (Fn) versus steady-state levels of isoflurane dose showed a progressive decrease in Fn for both high and medium drive levels, whereas for low drive most neurons fired tonically at all MAC levels with little change in Fn. Peak phrenic activity showed a similar but more pronounced decline with increased MAC for all levels of CO2 drive. Increasing isoflurane dose caused a downward, predominantly parallel shift of the CO2 response curves for both expiratory neuronal and phrenic neural activities. Phrenic activity ceased at 2-2.5 MAC isoflurane for all CO2 drive levels, whereas EBS neurons continued to fire tonically at the same depth at 30-50% of Fn at 1 MAC for the high level. These studies suggest that phrenic (inspiratory) activity is more sensitive than EBS neurons to isoflurane and that increases in CO2 drive can only partially offset the depressant effect of isoflurane on central respiratory activities.

Anesthesia, Inhalation↗

Transesophageal echocardiographic in total anomalous pulmonary venous drainage: hypotension caused by compression of the pulmonary venous confluence during probe passage.

Compression of vascular and airway structures can complicate transducer passage and manipulation during transesophageal echocardiography. This case describes hemodynamic compromise caused by compression of the posterior pulmonary venous confluence by a transesophageal echocardiography probe during intraoperative evaluation in an infant with supracardiac total anomalous pulmonary venous drainage. Careful hemodynamic and airway monitoring during transesophageal echocardiography is required in all patients, particularly during initial probe insertion and esophageal passage.

Constriction↗