Coordination of breathing and swallowing in human infants

1981 ◽  
Vol 50 (4) ◽  
pp. 851-858 ◽  
Author(s):  
S. L. Wilson ◽  
B. T. Thach ◽  
R. T. Brouillette ◽  
Y. K. Abu-Osba
Keyword(s):  
Esophageal Pressure ◽  
Simultaneous Recording ◽  
Inspiratory Effort ◽  
Airway Closure ◽  
Human Infants ◽  
Lung Volumes ◽  
Pharyngeal Pressure ◽  
Respiratory Airflow ◽  
Lower Lung ◽  
Airway Opening

Spontaneous nonfeeding swallows taken during wakefulness and sleep were identified in nine preterm infants by characteristic patterns in pharyngeal pressure, submental electromyogram, and respiratory airflow. Two hundred and seventeen swallows during ongoing respiration interrupted either inspiratory or expiratory airflow with airway closure for approximately 1 s. The duration of airway closure was independent of respiratory rate. A brief "swallow-breath" was associated with swallow onset in most instances. The respiratory nature of this movement was confirmed by simultaneous recording of a fall in pharyngeal or esophageal pressure and outward movement of the abdomen. Prolongation of the respiratory cycle was generally observed when a swallow interrupted ventilation at higher lung volumes, i.e., in late inspiration or early expiration. When the swallow interrupted ventilation at lower lung volume, i.e, in late expiration or early inspiration, the subsequent inspiratory effort was usually obstructed as it preceded airway opening at the end of the swallow synergism.

Pressure transmission across the respiratory system at raised lung volumes in infants

1994 ◽  
Vol 77 (2) ◽  
pp. 1015-1020 ◽  
Author(s):  
D. J. Turner ◽  
C. J. Lanteri ◽  
P. N. LeSouef ◽  
P. D. Sly
Keyword(s):  
Lung Volume ◽  
Dynamic Pressure ◽  
Esophageal Pressure ◽  
Tidal Range ◽  
Lung Volumes ◽  
Pressure Transmission ◽  
Airway Opening ◽  
Forced Expiratory Flow ◽  
End Tidal ◽  
Volume Range

Forced expiratory flow-volume (FEFV) curves can be generated from end-tidal inspiration in infants with use of an inflatable jacket. We have developed a technique to raise lung volume in the infant before generation of FEFV curves. Measurements of pressure transmission to the airway opening by use of static maneuvers have shown no change with increasing lung volume above end-tidal inspiration. The aim of this study was to determine, under dynamic conditions (i.e., during rapid thoracic compression), whether the efficiency of pressure transmission across the chest wall is altered by raising lung volume above the tidal range. Dynamic pressure transmission (Ptx,dyn) was measured in five infants (age 6–17 mo). Jacket pressure (Pj), esophageal pressure, and volume were measured throughout passive and FEFV curves at lung volumes set by 10, 15, and 20 cmH2O preset pressure. The group mean Ptx,dyn was 37 +/- 6% (SE) of Pj at end-tidal inspiration, and no change was seen with further increases in lung volume. However, a mean decrease in Ptx,dyn of 42% was evident throughout the tidal volume range (i.e., from end-tidal inspiration to end expiration). Isovolume static pressure transmission (Ptx,st) was measured in three of the five infants by inflation of the jacket in a stepwise manner with the airway closed. Measurements were made at end-tidal inspiration and lung volumes at 10, 15, and 20 cmH2O preset pressure. Resulting changes in Pj, esophageal pressure, and airway opening pressure were compared using linear regressions to determine Ptx,st.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of serotonin on expiratory pulmonary resistance in cats

1990 ◽  
Vol 68 (6) ◽  
pp. 2419-2425 ◽  
Author(s):  
M. Skaburskis ◽  
F. Shardonofsky ◽  
J. Milic-Emili
Keyword(s):  
Atmospheric Pressure ◽  
Pulmonary Resistance ◽  
Opening Pressure ◽  
Lung Volumes ◽  
Pressure Flow ◽  
Mechanically Ventilated ◽  
Flow Dependence ◽  
Lower Lung ◽  
Airway Opening ◽  
Lung Deflation

In five anesthetized paralyzed cats, mechanically ventilated with tidal volumes of 36-48 ml, the isovolume pressure-flow (IVPF) relationships of the lung were studied under control conditions and during serotonin-induced bronchoconstriction. At the end of a tidal inspiration, airway opening pressure was set between +3 and -15 cmH2O for single tidal expirations. After control measurements, animals were treated with progressively increasing doses of intravenous serotonin (10, 20, 50, and 100 micrograms.kg-1.min-1) and all measurements were repeated at each dose. No animal became flow limited during passive expiration against atmospheric pressure. Disregarding flow-limited segments, IVPF plots for three lung volumes showed that the resistive pressure-flow relationships were curvilinear under all conditions, thus fitting Rohrer's equation. Under control conditions and during the lowest dose of serotonin, the volume dependence of pulmonary resistance (RL) tended to balance its flow dependence so that during lung deflation against atmospheric pressure RL remained nearly constant. However, as bronchoconstriction became more pronounced, RL often increased disproportionately at the lower lung volumes. Changes in expiratory RL with serotonin relative to control values varied according to the flow rates used to make comparisons. The technique used to determine RL will partly determine the results obtained.

Mechanism of the lung-deflating action of the canine diaphragm at extreme lung inflation

2012 ◽  
Vol 112 (8) ◽  
pp. 1311-1316 ◽  
Author(s):  
Dimitri Leduc ◽  
Matteo Cappello ◽  
Pierre Alain Gevenois ◽  
André De Troyer
Keyword(s):  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Pleural Pressure ◽  
Phrenic Nerve Stimulation ◽  
Lung Volumes ◽  
Lung Inflation ◽  
Lower Lung ◽  
Airway Opening ◽  
Radiopaque Markers ◽  
Phrenic Nerves

When lung volume in animals is passively increased beyond total lung capacity (TLC; transrespiratory pressure = +30 cmH2O), stimulation of the phrenic nerves causes a rise, rather than a fall, in pleural pressure. It has been suggested that this was the result of inward displacement of the lower ribs, but the mechanism is uncertain. In the present study, radiopaque markers were attached to muscle bundles in the midcostal region of the diaphragm and to the tenth rib pair in five dogs, and computed tomography was used to measure the displacement, length, and configuration of the muscle and the displacement of the lower ribs during relaxation at seven different lung volumes up to +60 cmH2O transrespiratory pressure and during phrenic nerve stimulation at the same lung volumes. The data showed that 1) during phrenic nerve stimulation at 60 cmH2O, airway opening pressure increased by 1.5 ± 0.7 cmH2O; 2) the dome of the diaphragm and the lower ribs were essentially stationary during such stimulation, but the muscle fibers still shortened significantly; 3) with passive inflation beyond TLC, an area with a cranial concavity appeared at the periphery of the costal portion of the diaphragm, forming a groove along the ventral third of the rib cage; and 4) this area decreased markedly in size or disappeared during phrenic stimulation. It is concluded that the lung-deflating action of the isolated diaphragm beyond TLC is primarily related to the invaginations in the muscle caused by the acute margins of the lower lung lobes. These findings also suggest that the inspiratory inward displacement of the lower ribs commonly observed in patients with emphysema (Hoover's sign) requires not only a marked hyperinflation but also a large fall in pleural pressure.

scholarly journals Assessment of the influence of lung inflation state on the quantitative parameters derived from hyperpolarized gas lung ventilation MRI in healthy volunteers

2019 ◽  
Vol 126 (1) ◽  
pp. 183-192 ◽  
Author(s):  
Paul J. C. Hughes ◽  
Laurie Smith ◽  
Ho-Fung Chan ◽  
Bilal A. Tahir ◽  
Graham Norquay ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Lung Volume ◽  
Lung Ventilation ◽  
Lung Volumes ◽  
Lung Inflation ◽  
Longitudinal Measurements ◽  
Anatomical Images ◽  
Lower Lung ◽  
Ventilation Heterogeneity ◽  
Residual Capacity

In this study, the effect of lung volume on quantitative measures of lung ventilation was investigated using MRI with hyperpolarized 3He and 129Xe. Six volunteers were imaged with hyperpolarized 3He at five different lung volumes [residual volume (RV), RV + 1 liter (1L), functional residual capacity (FRC), FRC + 1L, and total lung capacity (TLC)], and three were also imaged with hyperpolarized 129Xe. Imaging at each of the lung volumes was repeated twice on the same day with corresponding 1H lung anatomical images. Percent lung ventilated volume (%VV) and variation of signal intensity [heterogeneity score (Hscore)] were evaluated. Increased ventilation heterogeneity, quantified by reduced %VV and increased Hscore, was observed at lower lung volumes with the least ventilation heterogeneity observed at TLC. For 3He MRI data, the coefficient of variation of %VV was <1.5% and <5.5% for Hscore at all lung volumes, while for 129Xe data the values were 4 and 10%, respectively. Generally, %VV generated from 129Xe images was lower than that seen from 3He images. The good repeatability of 3He %VV found here supports prior publications showing that percent lung-ventilated volume is a robust method for assessing global lung ventilation. The greater ventilation heterogeneity observed at lower lung volumes indicates that there may be partial airway closure in healthy lungs and that lung volume should be carefully considered for reliable longitudinal measurements of %VV and Hscore. The results suggest that imaging patients at different lung volumes may help to elucidate obstructive disease pathophysiology and progression. NEW & NOTEWORTHY We present repeatability data of quantitative metrics of lung function derived from hyperpolarized helium-3, xenon-129, and proton anatomical images acquired at five lung volumes in volunteers. Increased regional ventilation heterogeneity at lower lung inflation levels was observed in the lungs of healthy volunteers.

Effect of transpulmonary pressure on airway closure in immature and mature rabbits

1995 ◽  
Vol 78 (2) ◽  
pp. 505-512 ◽  
Author(s):  
R. S. Tepper ◽  
S. J. Gunst ◽  
C. M. Doerschuk ◽  
X. Shen ◽  
W. Bray
Keyword(s):  
Smooth Muscle ◽  
Small Volume ◽  
Transpulmonary Pressure ◽  
Lung Parenchyma ◽  
Tracheal Smooth Muscle ◽  
Airway Closure ◽  
Maximal Stimulation ◽  
In Vitro Sensitivity ◽  
Airway Opening

The transpulmonary pressures (Ptp values) at which airway closure occurred during maximal stimulation with methacholine were compared in 10 mature and 9 immature rabbit lungs by using an alveolar capsule technique to assess airway closure. After maximal constriction, airway opening and alveolar capsule pressures were recorded during small volume oscillations as Ptp was lowered from 12 to 4 cmH2O. At each Ptp, the proportion of alveolar capsules indicating airway closure was greater for the immature than for the mature lungs (P < 0.025). At Ptp of 4 cmH2O, only 20% of alveolar capsules indicated airway closure in the mature lungs in contrast to 85% indicating closure in the immature lungs (P < 0.001). The in vitro sensitivity of tracheal smooth muscle to acetylcholine and histamine was greater in tissues from immature than from mature rabbits. We conclude that the more frequent airway closure observed in immature rabbits could reflect maturational differences in the structure of the bronchi or lung parenchyma or differences in the coupling between the parenchyma and the airways.

Respiratory and Laryngeal Function During Whispering

1991 ◽  
Vol 34 (4) ◽  
pp. 761-767 ◽  
Author(s):  
Elaine T. Stathopoulos ◽  
Jeannette D. Hoit ◽  
Thomas J. Hixon ◽  
Peter J. Watson ◽  
Nancy Pearl Solomon
Keyword(s):  
Young Adults ◽  
Chest Wall ◽  
Voice Disorders ◽  
Normal Subjects ◽  
High Rate ◽  
Lung Volumes ◽  
Laryngeal Function ◽  
Tracheal Pressure ◽  
Lower Lung ◽  
Resistive Loads

Established procedures for making chest wall kinematic observations (Hoit & Hixon, 1987) and pressure-flow observations (Smitheran & Hixon, 1981) were used to study respiratory and laryngeal function during whispering and speaking in 10 healthy young adults. Results indicate that whispering involves generally lower lung volumes, lower tracheal pressures, higher translaryngeal flows, lower laryngeal airway resistances, and fewer syllables per breath group when compared to speaking. The use of lower lung volumes during whispering than speaking may reflect a means of achieving different tracheal pressure targets. Reductions in the number of syllables produced per breath group may be an adjustment to the high rate of air expenditure accompanying whispering compared to speaking. Performance of the normal subjects studied in this investigation does not resemble that of individuals with speech and voice disorders characterized by low resistive loads.

Reversible Inhibition of Lung Cell Number After Glucocorticoid Injection Into Fetal Rabbits to Enhance Surfactant Appearance

PEDIATRICS ◽  
1974 ◽  
Vol 53 (3) ◽  
pp. 358-361
Author(s):  
Robert V. Kotas ◽  
LeRoy C. Mims ◽  
Lana K. Hart
Keyword(s):  
Body Weight ◽  
Distress Syndrome ◽  
Cell Number ◽  
Lung Water ◽  
Human Infants ◽  
Adequate Nutrition ◽  
Body Weights ◽  
Lower Lung ◽  
Similar Weight ◽  
Catch Up

Recent enthusiasm concerning hydrocortisone therapy to prevent respiratory distress syndrome in human infants has aroused natural concern over possible untoward effects. There are both ethical and experimental reasons why human infants are not suitable for well-controlled investigation of untoward effects of steroid treatment. Therefore, we studied the effect of hydrocortisone injection on the lung cell number of the rabbit, an animal whose pulmonary development has been studied extensively. Fetal rabbits treated with single injections of hydrocortisone in utero had a lower number of lung cells when compared to similar weight controls. The decreased cell number, reflected by decreased DNA per lung, was also associated with lower lung weights and lower body weights but was not associated with significant changes in lung water or protein content. After birth, with adequate nutrition, "catch-up" in body weight occurred by 30 days' postnatal age. Animals killed at that time anti at 60 to 65 days had lung DNA content similar to untreated rabbits. Although lung cell number and body weight were decreased in fetal animals treated with a single dose of glucocorticoid late in gestation, with adequate nutrition growth of both body and lung recovered by 30 days' postnatal age.

scholarly journals Obesity alters the topographical distribution of ventilation and the regional response to bronchoconstriction

2020 ◽  
Vol 128 (1) ◽  
pp. 168-177 ◽  
Author(s):  
S. Rutting ◽  
S. Mahadev ◽  
K. O. Tonga ◽  
D. L. Bailey ◽  
J. R. Dame Carroll ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Body Mass Index ◽  
Body Mass ◽  
Respiratory System ◽  
Healthy Subjects ◽  
Airway Closure ◽  
Ventilation Distribution ◽  
Lung Volumes ◽  
Topographical Distribution ◽  
Lung Zone

Obesity is associated with reduced operating lung volumes that may contribute to increased airway closure during tidal breathing and abnormalities in ventilation distribution. We investigated the effect of obesity on the topographical distribution of ventilation before and after methacholine-induced bronchoconstriction using single-photon emission computed tomography (SPECT)-computed tomography (CT) in healthy subjects. Subjects with obesity ( n = 9) and subjects without obesity ( n = 10) underwent baseline and postbronchoprovocation SPECT-CT imaging, in which Technegas was inhaled upright and followed by supine scanning. Lung regions that were nonventilated (Ventnon), low ventilated (Ventlow), or well ventilated (Ventwell) were calculated using an adaptive threshold method and were expressed as a percentage of total lung volume. To determine regional ventilation, lungs were divided into upper, middle, and lower thirds of axial length, derived from CT. At baseline, Ventnon and Ventlow for the entire lung were similar in subjects with and without obesity. However, in the upper lung zone, Ventnon (17.5 ± 10.6% vs. 34.7 ± 7.8%, P < 0.001) and Ventlow (25.7 ± 6.3% vs. 33.6 ± 5.1%, P < 0.05) were decreased in subjects with obesity, with a consequent increase in Ventwell (56.8 ± 9.2% vs. 31.7 ± 10.1%, P < 0.001). The greater diversion of ventilation to the upper zone was correlated with body mass index ( rs = 0.74, P < 0.001), respiratory system resistance ( rs = 0.72, P < 0.001), and respiratory system reactance ( rs = −0.64, P = 0.003) but not with lung volumes or basal airway closure. Following bronchoprovocation, overall Ventnon increased similarly in both groups; however, in subjects without obesity, Ventnon only increased in the lower zone, whereas in subjects with obesity, Ventnon increased more evenly across all lung zones. In conclusion, obesity is associated with altered ventilation distribution during baseline and following bronchoprovocation, independent of reduced lung volumes. NEW & NOTEWORTHY Using ventilation SPECT-computed tomography imaging in healthy subjects, we demonstrate that ventilation in obesity is diverted to the upper lung zone and that this is strongly correlated with body mass index but is independent of operating lung volumes and of airway closure. Furthermore, methacholine-induced bronchoconstriction only occurred in the lower lung zone in individuals who were not obese, whereas in subjects who were obese, it occurred more evenly across all lung zones. These findings show that obesity-associated factors alter the topographical distribution of ventilation.

Density dependence of maximal expiratory flow before and during tracheal constriction in dogs

1986 ◽  
Vol 60 (3) ◽  
pp. 1060-1066 ◽  
Author(s):  
R. G. Castile ◽  
O. F. Pedersen ◽  
J. M. Drazen ◽  
R. H. Ingram
Keyword(s):  
Density Dependence ◽  
Lung Volumes ◽  
Maximal Expiratory Flow ◽  
Volume Curve ◽  
Before And After ◽  
Lower Lung ◽  
Flow Volume Curve ◽  
Expiratory Flow ◽  
Longitudinal Extension ◽  
Central Airway

The effect of carbachol-induced central bronchoconstriction on density dependence of maximal expiratory flow (MEF) was assessed in five dogs. MEFs were measured on air and an 80% He-20% O2 mixture before and after local application of carbachol to the trachea. Airway pressures were measured using a pitot-static probe, from which central airway areas were estimated. At lower concentrations of carbachol the flow-limiting site remained in the trachea over most of the vital capacity (VC), and tracheal area and compliance decreased in all five dogs. In four dogs, decreases in choke point area predominated and produced decreases in flows. In one dog the increase in airway “stiffness” apparently offset the fall in area to account for an increase in MEF. Density dependence measured as the ratio of MEF on HeO2 to MEF on air at 50% of VC increased in all five dogs. Increases in density dependence appeared to be related to increases in airway stiffness at the choke point rather than decreases in gas-related airway pressure differences. Lower concentrations produced a localized decrease in tracheal area and extended the plateau of the flow-volume curve to lower lung volumes. Higher concentrations caused further reductions in tracheal area and greater longitudinal extension of bronchoconstriction, resulting in upstream movement of the site of flow limitation at higher lung volumes. Density dependence increased if the flow-limiting sites remained in the trachea at mid-VC but fell if the flow-limiting site had moved upstream by that volume.

Effect of previous volume history on airway closure

1983 ◽  
Vol 55 (2) ◽  
pp. 294-299
Author(s):  
H. W. Greville ◽  
L. J. Slykerman ◽  
P. A. Easton ◽  
N. R. Anthonisen
Keyword(s):  
Regional Distribution ◽  
Lung Parenchyma ◽  
Breath Hold ◽  
Closing Volume ◽  
Airway Closure ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Normal Humans ◽  
Volume History ◽  
Previous Volume

We studied the effect of volume history on airway closure in six healthy males ranging from 32 to 67 yr of age. The method used was to compare the regional distribution of 133Xe boluses distributed according to N2O uptake during open-glottis breath-hold maneuvers with the regional distribution of boluses of intravenously injected 133Xe. Measurements were made at two lung volumes, one close to residual volume (RV) and the other just below closing volume. The required volume was reached either by expiring from total lung capacity or by inspiring from RV. Although there was considerable airway closure in the basal regions of the lungs at both lung volumes studied, the degree of airway closure was not dependent on the previous volume history. We conclude that the airways concerned with closure have a volume-pressure hysteresis similar to that of the lung parenchyma. Furthermore in normal humans the volume-pressure hysteresis of the lung is not secondary to airway closure.

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