The role of pulmonary stretch receptor discharge and volume feedback in modulation of tracheobronchial cough is not fully understood. The current study investigates the effect of expiratory occlusion with or without preceding inspiratory resistance (delivery of tidal or cough volume by the ventilator lasting over the active cough expiratory period) on the cough motor pattern. Experiments on 9 male cats under pentobarbital sodium anesthesia have shown that inspiratory resistance followed by expiratory occlusion increased cough inspiratory and expiratory efforts and prolonged several time intervals (phases) related to muscle activation during cough. Expiratory occlusion (at regular cough volume) decreased number of coughs, increased amplitudes of abdominal electromyographic activity, inspiratory and expiratory esophageal pressure during cough and significantly prolonged cough temporal features. Correlation analysis supported major changes in cough expiratory effort and timing due to the occlusion. Our results support a high importance of volume feedback, including that during cough expulsion, for generation and modulation of cough motor pattern with obstruction or expiratory airway resistances, the conditions present during various pulmonary diseases.
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http://dx.doi.org/10.1016/j.resp.2018.12.006 | DOI Listing |
Curr Opin Crit Care
February 2025
Intensive Care Volwassenen, Erasmus Medical Center, Rotterdam, The Netherlands.
Purpose Of Review: To summarize basic physiological concepts of breathing effort and outline various methods for monitoring effort of inspiratory and expiratory muscles.
Recent Findings: Esophageal pressure (Pes) measurement is the reference standard for respiratory muscle effort quantification, but various noninvasive screening tools have been proposed. Expiratory occlusion pressures (P0.
Curr Opin Crit Care
February 2025
Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Ann Am Thorac Soc
October 2024
University of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, Ontario, Canada.
Intensive Crit Care Nurs
February 2025
Key Laboratory of Clinical Evaluation Technology for Medical Device of Zhejiang Province, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, PR China; Department of Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, PR China. Electronic address:
Background: The diaphragm is crucial for ventilator weaning, but its specific impact on weaning indicators needs further clarification. This study investigated the variability in weaning outcomes across different diaphragm function populations and the value of respiratory drive and inspiratory effort in weaning.
Methods: This observational case-control study enrolled patients on mechanical ventilation for more than 48 h and completed a 30-minute spontaneous breathing trial (SBT) with pressure-support ventilation for the first time.
Crit Care
August 2024
Department of Intensive Care, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Importance: Maneuvers assessing fluid responsiveness before an intravascular volume expansion may limit useless fluid administration, which in turn may improve outcomes.
Objective: To describe maneuvers for assessing fluid responsiveness in mechanically ventilated patients.
Registration: The protocol was registered at PROSPERO: CRD42019146781.
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