Apnea prolongation via short-term inhibition.

Central apneas during sleep are frequently of longer duration than predicted and persist despite high levels of chemical stimuli. We provide evidence that suggests that this apnea prolongation represents a central inertia in the control system mediated by reciprocal inhibition of inspiration.

Frequency and volume thresholds for inhibition of inspiratory motor output during mechanical ventilation.

We quantified volume and frequency thresholds necessary for the inhibition of respiratory motor output during prolonged normocapnic mechanical ventilation in healthy subjects during wakefulness (n = 7) and NREM sleep (n = 5). Subjects were ventilated at eupneic frequency (fR) with 3 min step-wise increases in tidal volume (VT), or at eupneic VT with step-wise increases in fR, or by combinations of these two parameters. Inhibition of respiratory motor output was determined using mask pressure and, when available, esophageal pressure and diaphragmatic EMG.

Some effects of vagal blockade on abdominal muscle activation and shortening in awake dogs.

1. The mechanisms of abdominal muscle activation are thought to be different during expiratory threshold loading (ETL) compared with hypercapnia. Our objectives in the present study were to determine the effects of removing excitatory vagal feedback on abdominal muscle activation, shortening and pattern of recruitment during ETL and hypercapnia.

Neuromechanical regulation of respiratory motor output in ventilator-dependent C1-C3 quadriplegics.

To evaluate the role of phrenic and sternocleidomastoid afferents as alternate sources of inhibitory feedback during mechanical ventilation, we studied five C2-C3 quadriplegics with sensory denervation of the rib cage and diaphragm, six C1-C2 quadriplegics with additional loss of sensory feedback from the neck muscles, and seven normal subjects. We compared the return of inspiratory muscle activity [the recruitment threshold (PCO2RT)] during mechanical ventilation between subject groups after stepwise increases in end-tidal PCO2 (PETCO2) either by increasing the inspired fraction of CO2 (FICO2), decreasing tidal volume (VT; 50 ml/min), or decreasing frequency (f; 1 breath/2 min). Normal subjects were mechanically hyperventilated via a nasal mask until inspiratory activity was undetectable.

The effect of anesthesia on abdominal muscle resting length and shortening in awake dogs.

The objectives of this study were to examine the effects of anesthesia and implantation of sonomicrometer transducers on tonic and phasic expiratory activity of the abdominal muscles. Eight tracheotomized dogs were chronically instrumented with sonomicrometer transducers placed in each of the four abdominal muscles. The dogs were studied in the lateral decubitus position immediately after transducer implantation, while under halothane anesthesia, and then in the awake dogs 2 to 3 days postimplantation, and repeatedly over a 2- to 8-week period.

Regional diaphragm shortening measured by sonomicrometry.

Diaphragmatic shortening measured by sonomicrometry has been compared in the two major anatomic segments, costal and crural. Data obtained by videofluoroscopy found a variation in subsegmental shortening within segments (Sprung et al. J.

Apnea after normocapnic mechanical ventilation during NREM sleep.

We determined whether normocapnic mechanical ventilation at high tidal volume (VT) and breathing frequency (f) during non-rapid-eye-movement (NREM) sleep would cause apnea. Seven normal sleeping subjects were placed on assist-control mechanical ventilation (i.e.

Abdominal muscle activity during hypercapnia in awake dogs.

We previously found the internal abdominal muscle layer to be preferentially recruited during expiratory threshold loading in anesthetized and awake dogs. Expiratory threshold loading increases end-expiratory lung volume and hence can activate reflex pathways such as tonic vagal reflexes, which could influence abdominal muscle recruitment. Our objectives in the present study were to determine the effects of hypercapnia on abdominal muscle activation and the pattern of recruitment in awake dogs.

Apnoea following normocapnic mechanical ventilation in awake mammals: a demonstration of control system inertia.

1. Inhibition of inspiratory muscle activity from volume-related feedback during mechanical ventilation has been shown previously. To determine if this neuromechanical inhibition displays a memory effect, the duration of expiration immediately following cessation of mechanical ventilation was assessed in eight normal subjects.

Effects of posture on abdominal muscle shortening in awake dogs.

The objective of this study was to examine the effects of posture on tonic and phasic expiratory activity of the abdominal muscles in awake dogs. Six tracheostomized dogs were chronically instrumented with sonomicrometer transducers and bipolar electromyographic electrodes placed in each of the four abdominal muscles. To determine the effects of posture on tonic and phasic activity of individual abdominal muscles, muscle resting length (Lr) and tidal length changes (%Lr), respectively, were measured in awake dogs in the left lateral decubitus (LLD), sitting, and standing (STAND) positions.

Abdominal muscle activation by expiratory threshold loading in awake dogs.

Abdominal muscle activation produced by expiratory threshold loading (ETL) helps prevent an increase in FRC thus, optimizing diaphragm length and defending VT. However, anesthesia may affect abdominal muscle activation, and the pattern of recruitment and level of activation of individual abdominal muscles may well be dependent on body position. Therefore, individual abdominal muscle response to ETL was assessed in awake dogs, lying in the lateral decubitus position.

Expiratory muscle activity in the awake and sleeping human during lung inflation and hypercapnia.

Expiratory muscle activity has been shown to occur in awake humans during lung inflation; however, whether this activity is dependent on consciousness is unclear. Therefore we measured abdominal muscle electromyograms (intramuscular electrodes) in 13 subjects studied in the supine position during wakefulness and non-rapid-eye-movement sleep. Lung inflation was produced by nasal continuous positive airway pressure (CPAP).

Effect of lung inflation and upright posture on diaphragmatic shortening in dogs.

In an earlier study (Road and Leevers (1988), J. Appl. Physiol.

Respiratory muscle coordination and diaphragm length during expiratory threshold loading.

Active expiration is produced by the abdominal muscles and the rib cage expiratory muscles. We hypothesized that the relative contribution of these two groups to expiration would affect diaphragmatic length and, hence, influence the subsequent inspiration. To address this question we measured the respiratory muscle response to expiratory threshold loading in spontaneously breathing anesthetized dogs.

Inspiratory and expiratory muscle function during continuous positive airway pressure in dogs.

Continuous positive airway pressure (CPAP) is known to produce activation of the expiratory muscles. Several factors may determine whether this activation can assist inspiration. In this study we asked how and to what extent expiratory muscle contraction can assist inspiration during CPAP.

Mechanical response to hyperinflation of the two abdominal muscle layers.

Abdominal muscle length changes and activity were directly examined in vivo with the use of the techniques of sonomicrometry and electromyography, respectively, in nine supine anesthetized dogs. Expiratory threshold loading was utilized to stimulate recruitment of the abdominal muscles, and lung inflations produced the passive relationships. The internal layer, consisting of the internal oblique and transversus abdominis, shortened more in expiration than the external layer, consisting of the external oblique and rectus abdominis.

Effect of lung inflation on diaphragmatic shortening.

The effect of lung inflation on chest wall mechanics was studied in 11 vagotomized pentobarbital sodium-anesthetized dogs. Diaphragmatic shortening (percent change from initial length at functional residual capacity, %LFRC) and transdiaphragmatic pressure swings (delta Pdi) were compared with control values over a range of positive-pressure breathing that produced a maximum increase in lung volume to 40% of inspiratory capacity. There was no change in the electromyogram of the diaphragm or parasternal intercostals during positive-pressure breathing.