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Contractile characteristics and operating lengths of canine neck inspiratory muscles.

The neck inspiratory muscles are recruited to support breathing under numerous conditions. To gain insight into their synergistic actions we examined the isometric contractile properties of bundles from canine scalene and sternomastoid muscles. In addition, we also related the length of the neck muscles, measured sonomicrometrically in vivo at different lung volumes and body positions, to their optimal force-producing length (Lo) determined in vitro. We found that the speed of the sternomastoid is somewhat faster than that of the scalene owing to a shorter relaxation rate; the sternomastoid generates higher forces at submaximal stimulation frequencies than the scalene; the maximal tetanic force corrected for cross-sectional area is the same for both neck muscles; the neck muscles are significantly faster than the canine costal diaphragm; at supine functional residual capacity (FRC), the scalene is operating at a length corresponding to 85% Lo, whereas the sternomastoid is significantly shorter at 75% Lo; increasing lung volume shortens both muscles slightly, the length at supine total lung capacity being approximately 5% shorter than at FRC; and in the upright posture, both neck muscles lengthen toward their Lo, with the sternomastoid lengthening more than the scalene. We conclude that the scalene is a more effective force generator than the sternomastoid with the animal lying supine; the neck muscles appear to maintain their force-generating potential regardless of the lung volume; and the force-generating potential of the neck muscles is greatly enhanced with the animal in the upright vs. the supine position. This may contribute to the augmented rib cage motion characteristic of breathing in the upright posture.

Animals↗

Canine parainfluenza type 2 bronchiolitis increases histamine responsiveness in beagle puppies.

Histamine hyperresponsiveness with viral bronchiolitis may depend on previous exposures to viruses or to other pathogens. We studied 32 outbred beagle puppies 80 to 155 days of age who were raised in isolation and who were specific pathogen-free. Puppies were inoculated with canine parainfluenza type 2 (CPI2, n = 8), Bordetella bronchiseptica (Bb, n = 7), or both CPI2 and Bb (CPI2-Bb, n = 9). Control puppies (C, n = 8) were not inoculated. The puppies were anesthetized with sodium thiopental (5 mg/kg) and chloralose (80 mg/kg) and were ventilated mechanically. Lung resistance (RL), dynamic lung compliance (Cdyn), functional residual capacity (FRC), and responsiveness to aerosolized histamine were measured 3 days prior to inoculation (Day -3), on the day of inoculation (Day 0), and on Days 3-4, 6, 8-10, and 12-14 after inoculation. Histamine responsiveness was measured as: (1) the concentration of histamine base that increased RL to 150% (PC 150% RL) or decreased Cdyn to 75% (PC 75% Cdyn) of the response to saline (RL sal and Cdyn sal, respectively), and (2) the change in RL or Cdyn after inhalation of 11 mg/ml of histamine when compared with RL sal and Cdyn sal. On Day 0 there were no significant (p greater than 0.05) differences among groups with regard to age-corrected weights, FRC, RL, Cdyn, or histamine responsiveness. Control puppies remained healthy, and their pulmonary function and histamine responsiveness did not change. CPI2-Bb puppies increased RL and decreased FRC on Day 3-4, and were moderately ill and histamine-hyperresponsive on Day 3-4 and on Day 6.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗

Maturation of respiratory control in unanesthetized newborn rabbits.

The maturation of control of breathing was studied in unanesthetized rabbit pups breathing room air in a body plethysmograph during the first 8 postnatal days. Measurements include pulmonary ventilation (VE), tidal volume (VT), inspiratory (TI) and total breathing cycle (Ttot) durations, TI/Ttot, mean inspiratory flow (VT/TI), and tracheal pressure developed by the inspiratory muscles 0.1 and 0.2 s after the onset of inspirations with airways occluded at functional residual capacity (P0.1 and P0.2). All of the above variables increased progressively from the 1st to the 8th day, except for P0.1, P0.2, and TI/Ttot which remained constant. The constancy of TI/Ttot implies that the increase in VE with age was due entirely to increased VT/TI. The constancy of P0.1 and P0.2 implies that the increase in VT/TI with age was due to decreased "effective" impedance of the respiratory system. The latter probably mainly reflects increased compliance and decreased flow resistance with growth. The results also show that during the first 8 days of life there is a progressive shift to the right in the VT vs. TI relationship.

Aging↗

The effects of nebulized salbutamol, external positive end-expiratory pressure, and their combination on respiratory mechanics, hemodynamics, and gas exchange in mechanically ventilated chronic obstructive pulmonary disease patients.

We hypothesized that combined salbutamol and external positive end-expiratory pressure (PEEPe) may present additive benefits in chronic obstructive pulmonary disease (COPD) exacerbation. In 10 anesthetized, mechanically ventilated, and bronchodilator-responsive COPD patients exhibiting moderate intrinsic PEEP (PEEPi), we assessed respiratory system (rs) mechanics, hemodynamics, and gas exchange at (a) baseline (zero PEEPe [ZEEPe]), (b) 30 min after 5 mg of nebulized salbutamol administration (ZEEPe-S), (c) 30 min after setting PEEPe at baseline PEEPi level (PEEPe), and (d) 30 min after 5 mg of nebulized salbutamol administration with PEEPe maintained unchanged (PEEPe-S). Return of determined variable values to baseline values was confirmed before PEEPe application. Relative to ZEEPe, (a) at ZEEP-S, PEEPi (4.8 +/- 0.7 versus 7.0 +/- 1.1 cm H(2)O), functional residual capacity change (115.6 +/- 23.1 versus 202.1 +/- 46.0 mL), minimal rs (airway) resistance (9.3 +/- 1.4 versus 11.8 +/- 2.2 cm H(2)O.L(-1).s(-1)), and additional rs resistance (5.2 +/- 1.4 versus 7.2 +/- 1.3 cm H(2)O.L(-1).s(-1)) were reduced (P < 0.01), and hemodynamics were improved; (b) at PEEPe, PEEPi (3.7 +/- 1.3 cm H(2)O) was reduced (P < 0.01), and gas exchange was improved; and (c) at PEEPe-S, PEEPi (2.0 +/- 1.2 cm H(2)O) was minimized, and rs mechanics (static rs elastance included), hemodynamics, and gas exchange were improved. Conclusively, in carefully preselected COPD patients, bronchodilation/PEEPe exhibits additive benefits.

Aerosols↗

High-frequency oscillatory ventilation compared with conventional mechanical ventilation in the treatment of respiratory failure in preterm infants: assessment of pulmonary function at 9 months of corrected age. HiFi Study Group.

In a comparison of the outcome of high-frequency oscillatory ventilation (HFO) and conventional mechanical ventilation (intermittent mandatory ventilation (IMV] in newborn infants, the degree of late pulmonary damage in these infants was assessed in a multicenter trial by examining their pulmonary status, including pulmonary function test results at 9 months of corrected age. A total of 432 infants were followed, 222 in the IMV group and 210 in the HFO group. Two-hundred twenty-three infants had their pulmonary mechanics measured, 118 in the IMV group and 105 in the HFO group. There were no significant differences between the two groups in conditions known to predispose infants to chronic lung disease. At 9 months of age, both groups has similar growth and a similar incidence of respiratory tract infections and hospital readmissions, and of retractions and episodes of wheezing. None of the pulmonary mechanics measurements differed. Forced expiratory flow at functional residual capacity was decreased (132 +/- 86 vs 135 +/- 92 ml/sec in the IMV and HFO groups, respectively), peak-to-peak esophageal pressure change was elevated (14.4 +/- 5.7 vs 13.5 +/- 5.7 cm H2O), dynamic compliance was in the low normal range (1.2 +/- 0.5 vs 1.3 +/- 0.6 ml/cm H2O/kg), and total pulmonary resistance was elevated (63 +/- 43 vs 57 +/- 34 cm H2O/L/sec) when the measurements were compared with normal values. The results indicate that in both groups, 30% to 40% of infants survived with chronic pulmonary changes similar to those described in infants with bronchopulmonary dysplasia. The use of high-frequency ventilation, in comparison with IMV, did not improve long-term pulmonary outcome.

Carbon Dioxide↗

Infants with upper respiratory illnesses have significant reductions in maximal expiratory flow.

We studied maximal expiratory flows at functional residual capacity (VmaxFRC) obtained by use of the chest compression technique in 9 infants who had signs of upper respiratory illness (URI) at the time of testing, and in 9 infants who were symptom-free but whose parents reported they had a URI in the previous month. When compared to 109 infants with no URI, infants with current URI had 40% lower VmaxFRC (mean +/- SD: 125.7 +/- 54.5 mL/s vs. 73.6 +/- 53.6 mL/s; P less than 0.01). Infants with a past URI had mean values for VmaxFRC (120.2 +/- 50.2 mL/s) that were not significantly different from those of infants with no URI. Changes in the shape of the flow-volume loop analogous to those reported in infants with lower airway obstruction were also noticed in infants with current URI. These findings suggest that, as in older children and adults, clinically unapparent alterations in lower airway function occur during URI in infants.

Analysis of Variance↗

Lung volume changes during histamine-induced bronchoconstriction in recurrently wheezy infants.

Respiratory inductance plethysmography was used to estimate changes in functional residual capacity (FRC) in seven recurrently wheezy infants undergoing histamine challenge. Inhalations of normal saline and doubling concentrations of histamine were given up to and including the provoking concentration (PC) that caused a significant fall in maximum flow at FRC (Vmax FRC) as measured using the inflatable jacket technique. Below the PC histamine in general caused small increases in FRC [9.4 +/- 7.6 ml (mean +/- SD) at half the provoking concentration]. However, larger increases were seen at the provoking concentration (26.6 +/- 15.6 ml). Inspection of flow-volume curves obtained before and after the larger changes in FRC suggested that the reduction in airflow measured by the change in Vmax FRC was underestimated.

Bronchial Provocation Tests↗

Volume characteristics of extra- and intraparenchymal segments of the canine pulmonary artery.

The volumes of the extraparenchymal segment (VpaEP) and intraparenchymal segment (VpaIP) of the pulmonary arterial tree were determined in intact anesthetized dogs during room air breathing and acute hypoxia. Total pulmonary arterial blood volume (Vpatotal) was calculated as the product of pulmonary blood flow and pulmonary arterial circulation time. An angiographic technique was used to estimate VpEP. VpaIP was calculated by subtracting VpaEP from Vpatotal. During room air breathing at functional residual capacity, mean +/- SD of VpaEP was 17.1 +/- 5.1 ml and of VpaIP was 31.7 +/- 20.8 ml, representing 40% and 60%, respectively, of Vpatotal. Vpatotal increased 22.2 +/- 10.5 ml during lung inflation, with proportional increases in VpaIP and VpaEP. VpaEP was found to be influenced equally by changes in transmural pulmonary arterial and transpulmonary pressures. Acute hypoxia was accompanied by an increase in pulmonary vascular resistance and a decrease in volume distensibility of the extraparenchymal segment. Vpatotal increased 76% without changes in the relative volume distribution of VpaEP and VpaIP. These findings can be best explained by active vasomotion with an increase in down-stream pulmonary vascular resistance.

Animals↗

Onset of respiration in infants delivered by cesarean section.

We studied the ventilatory parameters and the pattern of breathing including the onset of respiration in 20 healthy infants immediately after cesarean-section delivery. In eight of the infants further measurements were obtained at 60 min of life. The pattern of breathing immediately after delivery is very irregular with a marked tendency to keep the lung inflated mainly through interruptions of expiration. After the first expiration some air remains in the lung representing the formation of functional residual capacity (FRC). FRC obtained with the first breath is proportional to the previous inspired volume and is the largest contribution towards the full establishment of FRC. Tidal volume and FRC of the first breath are similar to that reported in babies delivered vaginally, which suggests that the forces required for lung inflation are similar in the two groups of infants. The first breath tends to be deeper and slower and has a longer expiratory time than subsequent breaths. At 60 min of life the respiratory pattern becomes more regular, tidal volume is further decreased, and respiratory frequency is increased through a reduction of expiratory time.

Adult↗

[Restrictive lung disease].

It was found that functional residual capacity (FRC) invariably decreased during inspiratory elastic loaded breathing and that its magnitude increased progressively with an increase in the intensity of the load. This response could not be explained by chemoreflexes nor neural reflexes. Because the sensation of dyspnea decreased at lowered FRC (FRC-0.5 liter) than that at FRC during elastic loading, we speculate that FRC decreased behaviorally during elastic loading to reduce the sensation of dyspnea. We found that the respiratory muscle became fatigued more easily at FRC than at lowered FRC during elastic loading. We therefore conclude that the decrease in FRC may be one of the compensatory mechanisms during elastic loaded breathing.

Functional Residual Capacity↗

Pulmonary mechanics during exercise in normal males.

A body plethysmograph adapted to contain the pedals of an electrically braked cycle ergometer was used to measure pulmonary mechanics during steady-state exercise in 12 normal male subjects aged 22-65 yr. During exercise there was a progressive increase in residual volume to 119% of the value at rest (P less than 0.01), but functional residual capacity and total lung capacity did not change. The maximum expiratory flow-volume (MEFV) curves did not change and flow rates during tidal breathing did not exceed the MEFV curve. Dynamic pulmonary compliance fell to 91.3% of the control value and static expiratory pulmonary compliance fell to 76.9% of the control value (P less than 0.05). Pulmonary resistance did not change during exercise. Transpulmonary pressure during tidal breathing was negative even at the highest power outputs. The fall in compliance may be due to an increase in pulmonary capillary blood volume. These results demonstrate the importance of measuring absolute thoracic gas volume and the elastic properties of the lung when comparing pulmonary mechanics at rest and during exercise.

Adult↗

Breath-by-breath alveolar oxygen transfer at the onset of step exercise in humans: methodological implications.

The effects of using different algorithms to estimate the time constant of changes in oxygen uptake at the onset of square-wave 120 W cycloergometric exercise were evaluated in seven subjects. The volume of oxygen taken up at the alveoli (VO(2Ai)) was determined breath-by-breath (BB) from the volume of O(2) transferred at the mouth (VO(2mi)) minus the corresponding volume changes in O(2) stores in the alveoli: VO(2Ai)= VO(2mi)-[V(Ai-1)(FO(2Ai)- FO(2Ai-1))+ FO(2Ai) x Delta V(Ai)], where V(Ai-1) is the alveolar volume at the end of the previous breath, FO(2Ai) and FO(2Ai-1) are estimated from the fractions of end-tidal O(2) in the current and previous breaths, respectively, and Delta V(Ai) is the change in volume during breath i. These quantities can be measured BB, with the exception of V(Ai-1) which must be assumed. The respiratory cycle has been defined as the time elapsing between identical fractions of expiratory gas in two successive breaths. Using this approach, since FO(2Ai)= FO(2Ai-1), any assumption regarding V(Ai-1) becomes unnecessary. In the present study, VO(2Ai) was calculated firstly, by using this approach, and secondly by setting different V(Ai-1) values (from 0 to FRC+0.5 l, where FRC is the functional residual capacity). Values for alveolar O(2) flow (VO(2Ai)), as calculated from the quotient of VO(2Ai) divided by breath duration, were then fitted bi-exponentially. The time constant of the phase II kinetics of VO(2Ai) (tau(2)) was linearly related to V(Ai-1), increasing from 36.6 s (V(Ai-1)=0) to 46.8 s (V(Ai-1)=FRC+0.5 l) while tau(2) estimated using the first approach amounted to 34.3 s. We concluded that, firstly, the first approach allowed us to calculate O(2A) during transitions in step exercise; and secondly, when using methods wherein V(Ai-1) must be assumed, tau(2) depended on V(Ai-1).

Adult↗

Lung volume calculations from 81Krm SPECT for the quantification of regional ventilation.

Lung volumes, calculated from 81Krm single-photon emission computed tomography (SPECT) of the lungs, were compared with functional residual capacity (FRC), measured with the helium dilution technique in controls and in patients with various pulmonary diseases. SPECT volume was greater than FRC, which was attributed to non-gas-containing structures in the lung such as the alveolar walls, the interstitium, the blood vessels and the blood, included in the SPECT volume. A good correlation (r = 0.91) was found between the two volumes and there was no difference in this relationship between patients and controls. It was concluded that the relative volume distribution, calculated from SPECT, can be used for the quantification of ventilation from 81Krm SPECT steady-state count distributions.

Adult↗

Method for estimating absolute lung volumes at constant inflation pressure.

A method has been devised for measuring functional residual capacity in the intact killed animal or absolute lung volumes in any excised lung preparation without changing the inflation pressure. This is achieved by titrating the absolute pressure of a chamber in which the preparation is compressed until a known volume of air has entered the lungs. This technique was used to estimate the volumes of five intact rabbit lungs and five rigid containers of known dimensions by means of Boyle's law. Results were found to agree to within +/- 1% with values determined by alternative methods. In the discussion the advantage of determining absolute lung volumes at almost any stage in a study of lung mechanics without the determination itself changing inflation pressure and, hence, lung volume is emphasized.

Animals↗

Physiologic changes induced by theophylline in the treatment of apnea in preterm infants.

Ten preterm infants (birth weight 0.970 to 2.495 kg) with apnea due to periodic breathing (apneic interval = 5 to 10 seconds) or with "serious apnea" (greater than or equal to 20 seconds) were studied before and after the administration of theophylline. We determined the incidence of apnea, respiratory minute volume, alveolar gases, arterial gases and pH, "specific" compliance, functional residual capacity, and work of breathing. Theophylline decreased the incidence of apnea (P less than .05), increased respiratory minute volume (P less than 0.001), decreased (PACO2 (and PaCO2 P less than 0.001), increased the slope of the CO2 response curve (P less than 0.02) with a significant shift to the left (P less than 0.02). These findings suggest that the decreased incidence of apnea after theophylline is associated with an increase in alveolar ventilation and increased sensitivity to CO2 with a pronounced shift of the CO2 response curve to the left. These data are consistent with the idea that apnea is a reflection of a depressed respiratory system.

Apnea↗

Respiratory neuromuscular output during breath holding.

The involuntary respiratory muscle contractions that occur during breath holding were found in almost all of 52 subjects and were regular in a majority. In detailed studies, subjects rebreathed a mixture of 8% CO2 in O2 and then held their breath on an occluded mouthpiece, with glottis open, at functional residual capacity. Contractions monitored as waves of negative pressure were reproducible and increased in amplitude and frequency through the breath hold, but the breakpoint did not always correspond to the same pressure or frequency. Frequency and the time derivative of pressure (dP/dt) of contractions were much higher during breath holding than frequency of breathing and dP/dt of occluded breaths at the same gas tensions during rebreathing. Contractions were reduced in amplitude after the subject took three breaths without altering gas tensions. The results are consistent with the hypothesis that contractions contribute to dyspnea in breath breath holding, but there is not a simple correlation between their magnitude and the degree of dyspnea.

Abdominal Muscles↗

Costal diaphragm curvature in the dog.

The curvature of the midcostal region of the diaphragm in seven dogs was determined at functional residual capacity (FRC) and end inspiration during spontaneous breathing and mechanical ventilation and at total lung capacity in the prone and supine positions. Metallic markers were attached to muscle fibers on the abdominal surface of the diaphragm, and the dog was allowed to recover from surgery. The three-dimensional positions of the markers were determined by biplane videofluoroscopy. A quadratic surface was fit to the bead positions. The principal axes of the quadratic surface lie nearly along and perpendicular to the muscle fibers. In both the supine and prone positions, the values of the principal curvatures were similar at FRC and end inspiration during spontaneous breathing, when muscle tension and transdiaphragmatic pressure both increase with increasing lung volume, and during mechanical ventilation and passive inflation to total lung capacity, when both decrease relative to their magnitude at FRC. No abrupt change of curvature, which might be expected at the edge of the zone of apposition, was apparent. The curvature along the muscle fiber was 0.35 +/- 0.07 cm-1; the curvature perpendicular to the muscle fiber was much smaller, 0.06 +/- 0.01 cm-1. The costal region of the diaphragm displaces and shortens as lung volume increases, but its shape, as described by its curvatures, does not change substantially.

Animals↗

Perinatal lung function and invasive antenatal procedures.

BACKGROUND: Second trimester amniocentesis has been associated with an excess of perinatal lung function abnormalities. Early amniocentesis might have a similar adverse effect, as could other invasive investigations carried out in the first trimester. METHODS: Plethysmographic measurements of thoracic gas volume (TGV) and airway resistance (Raw), from which specific conductance (sGaw) was calculated, were made in the perinatal period in non-sedated infants. In addition, functional residual capacity (FRC) was measured using a helium gas dilution technique. Measurements were made in 47 infants whose mothers had undergone early amniocentesis, 19 whose mothers had undergone chorion villus sampling, and 25 controls whose mothers had undergone no invasive antenatal procedures. RESULTS: The infants of mothers who had undergone early amniocentesis had higher TGV (95% CI -6.3 to 1.1 ml/kg) and Raw values (95% CI -10.68 to -5.23 cm H2O/l/s) and lower sGaw (0.11 to 0.84 l/cm H2O.s) and FRC (-5.17 to - 0.87 ml/kg) values than the controls. Infants whose mothers had undergone chorion villus sampling also differed significantly from the controls with higher Raw (-7.59 to -1.99 cm H2O/l/s) and lower sGaw values (0.11 to 0.24 l/cm H2O.s), and had lower Raw values than those in the early amniocentesis group (not significant). Logistic regression analysis, taking into account possible risk factors for abnormal lung function, showed that the procedures performed in the first trimester were independently associated with a high airways resistance. CONCLUSION: These results suggest that invasive procedures performed in the first trimester of pregnancy have an adverse effect on perinatal lung function.

Adult↗