Respiratory responses in reversible diaphragm paralysis

1981 ◽  
Vol 51 (5) ◽  
pp. 1150-1156 ◽  
Author(s):  
M. L. Nochomovitz ◽  
M. Goldman ◽  
J. Mitra ◽  
N. S. Cherniack
Keyword(s):  
Electrical Activity ◽  
Tidal Volume ◽  
Phrenic Nerve ◽  
Respiratory Activity ◽  
Vagus Nerves ◽  
Inspiratory Time ◽  
Transdiaphragmatic Pressure ◽  
Co2 Partial Pressure ◽  
Diaphragm Paralysis ◽  
Before And After

The effects of diaphragm paralysis on respiratory activity were assessed in 13 anesthetized, spontaneously breathing dogs studied in the supine position. Transient diaphragmatic paralysis was induced by bilateral phrenic nerve cooling. Respiratory activity was assessed from measurements of ventilation and from the moving time averages of electrical activity recorded from the intercostal muscles and the central end of the fifth cervical root of the phrenic nerve. The degree of diaphragm paralysis was evaluated from changes in transdiaphragmatic pressure and reflected in rib cage and abdominal displacements. Animals were studied both before and after vagotomy breathing O2, 3.5% CO2 in O2, or 7% CO2 in O2. In dogs with intact vagi, both peak and rate of rise of phrenic and inspiratory intercostal electrical activity increased progressively as transdiaphragmatic pressure fell. Tidal volume decreased and breathing frequency increased as a result of a shortening in expiratory time. Inspiratory time and ventilation were unchanged by diaphragm paralysis. These findings were the same whether O2 or CO2 in O2 was breathed. After vagotomy, no significant change in phrenic or inspiratory intercostal activity occurred with diaphragm paralysis in spite of increased arterial CO2 partial pressure. Ventilation and tidal volume decreased significantly, and respiratory timing was unchanged. These results suggest that mechanisms mediated by the vagus nerves account for the compensatory increase in respiratory electrical activity during transient diaphragm paralysis. That inspiratory time is unchanged by diaphragm paralysis whereas the rate or rise of phrenic nerve activity increases suggest that reflexes other than the Hering-Breuer reflex contribute to the increased respiratory response.

Role of the carotid chemoreceptors in regulation of inspiratory onset

1982 ◽  
Vol 52 (4) ◽  
pp. 863-868 ◽  
Author(s):  
G. Bowes ◽  
S. M. Andrey ◽  
L. F. Kozar ◽  
E. A. Phillipson
Keyword(s):  
Tidal Volume ◽  
Eye Movement ◽  
Co2 Concentration ◽  
Direct Proportion ◽  
Vagus Nerves ◽  
Inspiratory Time ◽  
Cuffed Endotracheal Tube ◽  
Carotid Bodies ◽  
Before And After

We studied the effect of intermittent tidal breaths of CO2-enriched air (3–9% CO2) on the duration of expiratory time (TE) in five trained dogs, before and after (3 dogs) bilateral surgical denervation of the carotid bodies (CBD). During studies the dogs lay quietly, either awake or in nonrapid-eye-movement sleep, and breathed through a cuffed endotracheal tube inserted via a chronic tracheostomy. Studies were conducted during bilateral blockade of the cervical vagus nerves (VB), achieved by circulating cold alcohol through radiators placed around exteriorized vagal skin loops. Prior to CBD, single breaths of CO2 significantly shortened TE and thus advanced the onset of the subsequent inspiration. Further, the decrease in TE induced by the CO2 stimulus was in direct proportion to the inspired CO2 concentration. Thus 3% CO2 shortened TE by 1.82 +/- 0.93 (SD) s, and 9% CO2 by 3.44 +/- 1.53 s. Changes in TE occurred in the absence of associated changes in either tidal volume or inspiratory time. After CBD, test breaths of CO2 failed to shorten TE during VB. We conclude that the carotid bodies have the ability to mediate changes in the timing of inspiratory onset in response to a transient CO2 stimulus.

Ventilatory CO2 drive in the tortoise Testudo horsfieldi

1980 ◽  
Vol 87 (1) ◽  
pp. 229-236
Author(s):  
G. Benchetrit ◽  
P. Dejours
Keyword(s):  
Tidal Volume ◽  
Air Flow ◽  
Respiratory Frequency ◽  
Vagus Nerves ◽  
Peripheral Chemoreceptors ◽  
Before And After ◽  
Flow Inhalation ◽  
Bilateral Vagotomy

1. Ventilation was recorded by pneumotachography, before and after bilateral vagotomy, in conscious tortoises (Testudo horsfieldi) (breathing 0, 2, 3 or 4% CO2 in air or oxygen). 2. Each breath consists of expiratory and inspiratory phases and an apneic plateau (absence of air flow). Inhalation of hypercapnic mixtures led to increased ventilatory flow, augmentation of tidal volume, and an increase in respiratory frequency through the shortening of the apneic plateau. 3. Intact tortoises breathing hypercapnic-hyperoxic mixtures hyperventilated less than with hypercapnic-normoxic mixtures. 4. In bivagotomized animals, the respiratory frequency decreased, the expiratory and inspiratory durations lengthened, and the apneic plateau was prolonged. The tidal volume was increased, but ventilation, nevertheless, decreased slightly. 5. Bivagotomized animals breathing hypercapnic-normoxic or hypercapnic-hyperoxic mixtures hyperventilated, but less than intact animals under the same conditions. 6. It is concluded that in tortoises there are: (1) peripheral chemoreceptors which are innervated by branches of the vagus nerves, and are sensitive to CO2; and (2) an extrathoracic, probably central, ventilatory CO2 drive.

Effect of digitalis on the diaphragm in anesthetized dogs

1987 ◽  
Vol 63 (1) ◽  
pp. 277-284 ◽  
Author(s):  
Y. Kikuchi ◽  
W. Hida ◽  
C. Shindoh ◽  
T. Chonan ◽  
H. Miki ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Stimulus Frequency ◽  
Dependent Manner ◽  
Phrenic Nerve Stimulation ◽  
Transdiaphragmatic Pressure ◽  
Mechanically Ventilated ◽  
Before And After ◽  
Residual Capacity ◽  
Anesthetized Dogs

We examined the effect of digitalis on diaphragmatic contractility and fatigability in 19 anesthetized mechanically ventilated dogs. The diaphragmatic force was assessed from transdiaphragmatic pressure (Pdi) developed at functional residual capacity against an occluded airway during cervical phrenic nerve stimulation. In a first group of five dogs, Pdi-stimulus frequency relationships were compared before and after administration of ouabain in doses of 0.01, 0.02, and 0.04 mg/kg. In a second group, diaphragmatic fatigue was produced by bilateral phrenic nerve stimulation at 30 Hz. Ten seconds of stimulation and 15 s of mechanical ventilation were repeated for 30 min. The rates of decrease in Pdi were compared between two groups, one of 0.05 mg/kg deslanoside-treated dogs (n = 7) and one of nontreated dogs (n = 7). After ouabain administration Pdi was significantly greater at each frequency in a dose-dependent manner. On the other hand, the rate of decrease in Pdi in the deslanoside group was significantly smaller than that in the nontreated group, whereas deslanoside did not greatly change the Pdi-frequency curves in fresh diaphragm. We conclude that ouabain improves contractility of the fresh diaphragm and that deslanoside has a protective effect against fatigability.

Sonomicrometric regional diaphragmatic shortening in awake sheep after thoracic surgery

1989 ◽  
Vol 67 (6) ◽  
pp. 2357-2368 ◽  
Author(s):  
A. Torres ◽  
W. R. Kimball ◽  
J. Qvist ◽  
K. Stanek ◽  
R. M. Kacmarek ◽  
...  
Keyword(s):  
Thoracic Surgery ◽  
Tidal Volume ◽  
Minute Ventilation ◽  
Respiratory Frequency ◽  
Quiet Breathing ◽  
Transdiaphragmatic Pressure ◽  
Right Thoracotomy ◽  
Before And After ◽  
End Tidal ◽  
End Tidal Co2

Through a right thoracotomy in seven sheep we chronically implanted sonomicrometry crystals and electromyographic electrodes in the costal and crural diaphragmatic regions. Awake sheep were studied during recovery for 4-6 wk, both during quiet breathing (QB) and during CO2 rebreathing. Tidal volume, respiratory frequency, and esophageal and gastric pressures were studied before and after surgery. Normalized resting length (LFRC) was significantly decreased for the costal segment on postoperative day 1 compared with postoperative day 28. Fractional costal shortening both during QB and at 10% end-tidal CO2 (ETCO2) increased significantly from postoperative days 1 to 28, whereas crural shortening did not change during QB but progressively increased at 10% ETCO2. Maximal costal shortening during electrophrenic stimulation was constant at 40% LFRC during recovery, although maximal crural shortening increased from 23 to 32% LFRC. Minute ventilation, tidal volume, and transdiaphragmatic pressure at 10% ETCO2 increased progressively after thoracotomy until postoperative day 28. Our results suggest there is profound diaphragmatic inhibition after thoracotomy and crystal implantation in sheep that requires at least 3-4 wk for stable recovery.

Central GABAergic mechanisms are involved in apnea induced by SLN stimulation in piglets

2001 ◽  
Vol 90 (4) ◽  
pp. 1570-1576 ◽  
Author(s):  
Jalal M. Abu-Shaweesh ◽  
Ismail A. Dreshaj ◽  
Musa A. Haxhiu ◽  
Richard J. Martin
Keyword(s):  
Electrical Stimulation ◽  
Phrenic Nerve ◽  
Superior Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Receptor Blocker ◽  
Inspiratory Time ◽  
Before And After ◽  
Four Levels ◽  
Stimulation Of

Stimulation of the superior laryngeal nerve (SLN) results in apnea in animals of different species, the mechanism of which is not known. We studied the effect of the GABAA receptor blocker bicuculline, given intravenously and intracisternally, on apnea induced by SLN stimulation. Eighteen 5- to 10-day-old piglets were studied: bicuculline was administered intravenously to nine animals and intracisternally to nine animals. The animals were anesthetized and then decerebrated, vagotomized, ventilated, and paralyzed. The phrenic nerve responses to four levels of electrical SLN stimulation were measured before and after bicuculline. SLN stimulation caused a significant decrease in phrenic nerve amplitude, phrenic nerve frequency, minute phrenic activity, and inspiratory time ( P < 0.01) that was proportional to the level of electrical stimulation. Increased levels of stimulation were more likely to induce apnea during stimulation that often persisted beyond cessation of the stimulus. Bicuculline, administered intravenously or intracisternally, decreased the SLN stimulation-induced decrease in phrenic nerve amplitude, minute phrenic activity, and phrenic nerve frequency ( P < 0.05). Bicuculline also reduced SLN-induced apnea and duration of poststimulation apnea ( P < 0.05). We conclude that centrally mediated GABAergic pathways are involved in laryngeal stimulation-induced apnea.

Breathing pattern of anesthetized humans during pancuronium-induced partial paralysis

1988 ◽  
Vol 64 (1) ◽  
pp. 78-83 ◽  
Author(s):  
T. Nishino ◽  
N. Yokokawa ◽  
K. Hiraga ◽  
Y. Honda ◽  
T. Mizuguchi
Keyword(s):  
Tidal Volume ◽  
Respiratory Muscles ◽  
Respiratory Frequency ◽  
Breathing Patterns ◽  
Inspiratory Time ◽  
Muscle Paralysis ◽  
Airway Occlusion ◽  
Enflurane Anesthesia ◽  
Before And After ◽  
The Face

We investigated the breathing patterns of 17 subjects anesthetized with enflurane before and after partial muscle paralysis produced by pancuronium bromide. In the face of significant muscle weakness produced by pancuronium, breathing patterns are characterized by decreases in both tidal volume and respiratory frequency. The decreased tidal volume corresponded to the decrease in occlusion pressure, indicating that the decreased tidal volume results solely from a decreased contractile force of the respiratory muscles. The decreased respiratory frequency was due to prolongation of both inspiratory and expiratory time without changing the ratio of the inspiratory time to the total breath time. Withdrawal of phasic vagal influence by airway occlusion before partial muscle paralysis revealed that an active Breuer-Hering inflation reflex was operative in only 8 of all 17 subjects. Since the contribution of the Breuer-Hering inflation reflex alone does not seem to account for the consistent decrease in respiratory frequency, some other mechanisms modulating respiratory frequency might be involved in the characteristic breathing patterns during partial muscle paralysis under enflurane anesthesia.

scholarly journals Bilateral diaphragmatic paralysis after kidney surgery

2015 ◽  
Vol 77 (2) ◽  
Author(s):  
S. Sozzo ◽  
P. Carratù ◽  
M.F. Damiani ◽  
V.A. Falcone ◽  
A. Palumbo ◽  
...  
Keyword(s):  
Turner Syndrome ◽  
Phrenic Nerve ◽  
Diaphragmatic Paralysis ◽  
Transdiaphragmatic Pressure ◽  
Neuralgic Amyotrophy ◽  
X Ray ◽  
Post Surgery ◽  
Diaphragm Paralysis ◽  
Chest X Ray ◽  
Kidney Angiomyolipoma

A 57-year-old woman underwent an enucleoresection of her right kidney angiomyolipoma. Two weeks later she was admitted to our hospital because of dyspnea at rest with orthopnea. The chest x-ray showed the elevation of both hemidiaphragms and the measurement of the sniff transdiaphragmatic pressure confirmed the diagnosis of bilateral diaphragmatic paralysis. A diaphragm paralysis can be ascribed to several causes, i.e. trauma, compressive events, inflammations, neuropathies, or it can be idiopathic. In this case, it was very likely that the patient suffered from post-surgery neuralgic amyotrophy. To our knowledge, there are only a few reported cases of neuralgic amyotrophy, also known as Parsonage- Turner Syndrome, which affects only the phrenic nerve as a consequence of a surgery in an anatomically distant site.

Vagotomy reverses apnea induced by high-frequency oscillatory ventilation

1981 ◽  
Vol 51 (6) ◽  
pp. 1484-1487 ◽  
Author(s):  
W. K. Thompson ◽  
B. E. Marchak ◽  
A. C. Bryan ◽  
A. B. Froese
Keyword(s):  
High Frequency ◽  
Airway Pressure ◽  
Respiratory Activity ◽  
High Frequency Oscillatory Ventilation ◽  
High Frequency Ventilation ◽  
Vagus Nerves ◽  
Co2 Partial Pressure ◽  
Oscillatory Ventilation ◽  
Frequency Ventilation ◽  
High Frequency Oscillatory

Apnea has been observed in both animals and patients during high-frequency oscillatory ventilation. The effects of vagotomy were studied during periods of oscillator-induced apnea in 11 pentobarbital-anesthetized dogs. The animals were intubated and breathing spontaneously. An arterial cannula was inserted for monitoring blood pressure and blood gases. Intratracheal airway pressure was measured, and respiratory activity was assessed using either an intrapleural catheter or esophageal balloon. The dogs then underwent high-frequency ventilation at 15 Hz. Apnea was induced by appropriate selection of volume displacement of the piston pump and the distal airway pressure in eucapnic animals. Segments of right and left vagus nerves were exposed in the neck, bathed in local anesthetic, and transected. Spontaneous ventilation resumed immediately in nine animals and could not be suppressed at the same CO2 partial pressure despite continuation of oscillation. We conclude that the apnea observed during high-frequency ventilation is mediated by active vagal inhibition of central respiratory activity and is usually reversed by vagotomy.

Effects of thoracic dorsal rhizotomies on the respiratory pattern in anesthetized cats

1977 ◽  
Vol 43 (1) ◽  
pp. 20-26 ◽  
Author(s):  
R. Shannon
Keyword(s):  
Tidal Volume ◽  
Respiratory Activity ◽  
Respiratory Rhythm ◽  
Respiratory Pattern ◽  
Thoracic Wall ◽  
Intercostal Muscle ◽  
Inspiratory Time ◽  
Expiratory Time ◽  
Intercostal Muscles ◽  
Dorsal Roots

Experiments were conducted to determine if thoracic wall proprioceptor afferents are involved in the modulation of respiratory activity during eupnea. The effects of elimination of thoracic wall afferents (thoracic dorsal rhizotomies (TDR) on tidal volume (VT), frequency (f), inspiratory time (ti) and expiratory time (te) were studied in vagotomized cats anesthetized with diallylbarbituric acid (Dial). Dorsal rhizotomies 1–12 resulted primarily in a decreased VT and ti, and an increased f. Further experiments were performed to determine if these changes in respiratory pattern could be correlated with known reflexes from the middle and lower intercostal muscles, or lungs, via thoracic dorsal roots. Afferents from these sources were eliminated by TDR 5–9, 10–13, and 1–4. TDR 1–4 had no significant effect on the respiratory pattern. TDR 5–9 and TDR 10–13 produced changes similar in direction to TDR 1–12. The results indicate that: a) afferents 1–4 from the upper intercostal muscles and lungs (sympathetic afferents) do not contribute significantly to the control of the spontaneous respiratory rhythm, and b) afferents via the middle thoracic roots, 5–9, and the lower thoracic roots, 10–13, contribute significantly to the rhythm. The results do not completely correlate with known intercostal reflexes, but it is suggested that elimination of intercostal muscle proprioceptor afferents is responsible for the observed effects of thoracic dorsal rhizotomies.

Respiratory modulation of the activity in postganglionic neurons supplying skeletal muscle and skin of the rat hindlimb

1993 ◽  
Vol 70 (3) ◽  
pp. 920-930 ◽  
Author(s):  
H. J. Habler ◽  
W. Janig ◽  
M. Krummel ◽  
O. A. Peters
Keyword(s):  
Skeletal Muscle ◽  
Tidal Volume ◽  
Phrenic Nerve ◽  
Sympathetic Activity ◽  
Artificial Ventilation ◽  
Sympathetic Outflow ◽  
Experimental Conditions ◽  
Before And After ◽  
Bilateral Vagotomy ◽  
Respiratory Modulation

1. The respiratory modulation of activity in postganglionic neurons of the lumbar sympathetic outflow to skeletal muscle and hairy skin of the hindlimb was studied in anesthetized rats, either breathing spontaneously or paralyzed and artificially ventilated, using single- and multifiber recordings. The activity of the neurons was analyzed with respect to the phrenic nerve discharges or with respect to the cycle of artificial ventilation under various experimental conditions. 2. In total, 19 single and 62 multiunit preparations supplying skeletal muscle and 42 single and 95 multiunit preparations supplying skin were analyzed. Qualitatively, both populations and single- and multiunit preparations exhibited similar patterns. The majority (187/218 preparations) exhibited a depression of activity during inspiration and a peak of activity during expiration that was mostly accentuated during early expiration. The remainder exhibited a peak of activity at the transition between expiration and inspiration (n = 15) or showed no respiratory modulation (n = 16). 3. Respiratory modulation in the postganglionic neurons was similar in animals breathing spontaneously and in those that were paralyzed and artificially ventilated. 4. Systemic hypercapnia and asphyxia in most cases enhanced both the peak of activity during early expiration and the depression of activity during inspiration. 5. No peripheral (reflex) component mediated by arterial baroreceptors was found in vagotomized animals that was related to the cycle of artificial ventilation using a tidal volume of 1-2 ml and a ventilation frequency of 70 +/- 7 (SD) strokes, min-1. However, a small ventilation-related rhythm of arterial baroreceptor activity recorded from the aortic nerve was found under these conditions. 6. Respiratory modulation of postganglionic activity was similar before and after bilateral vagotomy. 7. It is concluded that respiratory modulation of sympathetic activity in rats is less differentiated than in cats. The observed differences between neurons supplying different targets are only quantitative. Possible mechanisms involved in the generation of respiratory modulation are discussed.

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