Differential response of respiratory muscles to airway occlusion in infants

1985 ◽  
Vol 59 (3) ◽  
pp. 847-852 ◽  
Author(s):  
W. A. Carlo ◽  
M. J. Miller ◽  
R. J. Martin
Keyword(s):  
Total Duration ◽  
Respiratory Muscles ◽  
Upper Airway ◽  
Peak Amplitude ◽  
Emg Activity ◽  
Inspiratory Time ◽  
Surface Electrodes ◽  
Airway Occlusion ◽  
The Right ◽  
Respiratory Muscle Activity

The effect of end-expiratory occlusion on respiratory muscle activity was studied in 10 unsedated preterm infants during sleep. Electromyograms (EMG) of the upper airway were recorded from surface electrodes placed over the submental (SM) area; diaphragm (DIA) EMGs were obtained with identical electrodes over the right subcostal margin. Phasic SM EMG accompanied 56 +/- 36% of breaths during spontaneous breathing and increased to 80 +/- 26% (P less than 0.05) on the first inspiratory effort after occlusion. Occlusion increased peak amplitude (P less than 0.001) and total duration (P less than 0.005) of the SM EMG without significant changes in its initial rate of rise. In contrast, only the total duration of the DIA EMG increased (P less than 0.005) during occlusion. Inspiratory time increased from 470 +/- 120 to 720 +/- 210 ms (P less than 0.001) during the first occluded effort, but expiratory time did not change. With sustained occlusion, peak amplitude of the SM EMG progressively increased, but DIA EMG only significantly increased by the third occluded effort. Pharyngeal patency was invariably maintained throughout the induced airway occlusions. Sharp bursts of SM EMG activity coincided with resolution of spontaneous obstructive apneic episodes in four infants. The immediate increase in SM EMG associated with airway occlusion may be a mechanism that prevents the development of obstructive apnea.

scholarly journals Geniohyoid muscle function in awake canines

2003 ◽  
Vol 95 (2) ◽  
pp. 810-817 ◽  
Author(s):  
M. Yokoba ◽  
H. G. Hawes ◽  
P. A. Easton
Keyword(s):  
Muscle Function ◽  
Breathing Pattern ◽  
Muscle Length ◽  
Upper Airway ◽  
Mechanical Action ◽  
Emg Activity ◽  
Airway Occlusion ◽  
Lateral Decubitus ◽  
The Right ◽  
Emg Electrodes

The geniohyoid (Genio) upper airway muscle shows phasic, inspiratory electrical activity in awake humans but no activity and lengthening in anesthetized cats. There is no information about the mechanical action of the Genio, including length and shortening, in any awake, nonanesthetized mammal during respiration (or swallowing). Therefore, we studied four canines, mean weight 28.8 kg, 1.5 days after Genio implantation with sonomicrometry transducers and bipolar electromyogram (EMG) electrodes. Awake recordings of breathing pattern, muscle length and shortening, and EMG activity were made with the animal in the right lateral decubitus position during quiet resting, CO2-stimulated breathing, inspiratory-resisted breathing (80 cmH2O · l-1 · s), and airway occlusion. Genio length and activity were also measured during swallowing, when it shortened, showing a 9.31% change from resting length, and its EMG activity increased 6.44 V. During resting breathing, there was no phasic Genio EMG activity at all, and Genio showed virtually no movement during inspiration. During CO2-stimulated breathing, Genio showed minimal lengthening of only 0.07% change from resting length, whereas phasic EMG activity was still absent. During inspiratory-resisted breathing and airway occlusion, Genio showed phasic EMG activity but still lengthened. We conclude that the Genio in awake, nonanesthetized canines shows active contraction and EMG activity only during swallowing. During quiet or stimulated breathing, Genio is electrically inactive with passive lengthening. Even against resistance, Genio is electrically active but still lengthens during inspiration.

Surface Recordings of Respiratory Muscle Activity during Speech

1989 ◽  
Vol 32 (3) ◽  
pp. 657-667 ◽  
Author(s):  
David H. McFarland ◽  
Anne Smith
Keyword(s):  
Chest Wall ◽  
Muscle Activity ◽  
Respiratory Muscle ◽  
Respiratory Muscles ◽  
Emg Activity ◽  
Breathing Cycle ◽  
Surface Electrodes ◽  
Disk Electrodes ◽  
Respiratory Muscle Activity ◽  
Accessory Respiratory Muscles

Bipolar electromyographic (EMG) recordings were made from six chest wall and nasal sites with disk electrodes attached to the skin. Electrode locations were based on previous studies of nonspeech breathing and were designed to sample the activity of both primary and accessory respiratory muscles. EMG activity was sampled while subjects performed a series of speech and nonspeeeh tasks. The results revealed that surface electrodes could sample the activity of respiratory muscles during speech and other ventilatory tasks, particularly during the expiratory phases of the breathing cycle.

Effect of oxygenation on breath-by-breath response of the genioglossus muscle during occlusion

1991 ◽  
Vol 71 (4) ◽  
pp. 1231-1236 ◽  
Author(s):  
E. B. Gauda ◽  
J. L. Carroll ◽  
S. McColley ◽  
P. L. Smith
Keyword(s):  
Upper Airway ◽  
Peak Amplitude ◽  
Emg Activity ◽  
Genioglossus Muscle ◽  
Airway Occlusion ◽  
Sustained Activity ◽  
The Third ◽  
Adult Cats ◽  
Upper Airway Muscles ◽  
Different Levels

We investigated the effect of different levels of O2 tension (hypoxia, normoxia, and hyperoxia) on the breath-by-breath onset and peak electromyographic (EMG) activity of the genioglossus (GG) muscle during a five-breath end-expiratory tracheal occlusion of 20- to 30-s duration. GG and diaphragmatic (DIA) EMG activity were measured with needle electrodes in eight anesthetized tracheotomized adult cats. In response to occlusion, the increase in the number of animals with GG EMG activity was different during hypoxia, normoxia, and hyperoxia (P = 0.003, Friedman). During hypoxia, eight of eight of the animals had GG EMG activity by the third occluded effort. In contrast, during normoxia, only four of eight and, during hyperoxia, only three of eight animals had GG EMG activity throughout the entire five-breath occlusion. Similarly, at release of the occlusion, more animals had persistent GG EMG activity on the postocclusion breaths during hypoxia than during normoxia or hyperoxia. Breath-by-breath augmentation of peak amplitude of the GG and DIA EMGs on each occluded effort was accentuated during hypoxia (P less than 0.01) and abolished during hyperoxia (P = 0.10). These results suggest that hypoxemia is a major determinant of the rapidity of onset, magnitude, and sustained activity of upper airway muscles during airway occlusion.

Respiratory muscle responses to changes in chemoreceptor drive in infants

1990 ◽  
Vol 68 (3) ◽  
pp. 1041-1047 ◽  
Author(s):  
W. A. Carlo ◽  
J. M. DiFiore
Keyword(s):  
Preterm Infants ◽  
Respiratory Muscle ◽  
Muscle Activation ◽  
Respiratory Muscles ◽  
Upper Airway ◽  
Obstructive Apnea ◽  
Surface Electrodes ◽  
Posterior Cricoarytenoid ◽  
Upper Airway Muscles ◽  
Muscle Responses

Upper airway muscles and the diaphragm may have different quantitative responses to chemoreceptor stimulation. To compare the respiratory muscle responses to changes in CO2, 10 ventilator-dependent preterm infants (gestational age 28 +/- 1 wk, postnatal age 40 +/- 6 days, weight 1.4 +/- 0.1 kg) were passively hyperventilated to apnea and subsequently hypoventilated. Electromyograms from the genioglossus, alae nasi, posterior cricoarytenoid, and diaphragm were recorded from surface electrodes. Apneic CO2 thresholds of all upper airway muscles (genioglossus 46.8 +/- 4.3 Torr, alae nasi 42.4 +/- 3.6 Torr, posterior cricoarytenoid 41.6 +/- 3.2 Torr) were higher than those of the diaphragm (38.8 +/- 2.6 Torr, all P less than 0.05). Above their CO2 threshold levels, responses of all upper airway muscles appeared proportional to those of the diaphragm. We conclude that nonproportional responses of the respiratory muscles to hypercapnia may be the result of differences in their CO2 threshold. These differences in CO2 threshold may cause imbalance in respiratory muscle activation with changes in chemical drive, leading to upper airway instability and obstructive apnea.

Control of respiratory activity of the genioglossus muscle in micrognathic infants

1986 ◽  
Vol 61 (4) ◽  
pp. 1523-1533 ◽  
Author(s):  
J. L. Roberts ◽  
W. R. Reed ◽  
O. P. Mathew ◽  
B. T. Thach
Keyword(s):  
Upper Airway ◽  
Esophageal Pressure ◽  
Progressive Increase ◽  
Emg Activity ◽  
Nasal Breathing ◽  
Airway Patency ◽  
Tongue Muscle ◽  
Airway Occlusion ◽  
Pharyngeal Airway ◽  
Obstructive Sleep

The genioglossus (GG) muscle activity of four infants with micrognathia and obstructive sleep apnea was recorded to assess the role of this tongue muscle in upper airway maintenance. Respiratory air flow, esophageal pressure, and intramuscular GG electromyograms (EMG) were recorded during wakefulness and sleep. Both tonic and phasic inspiratory GG-EMG activity was recorded in each of the infants. On occasion, no phasic GG activity could be recorded; these silent periods were unassociated with respiratory embarrassment. GG activity increased during sigh breaths. GG activity also increased when the infants spontaneously changed from oral to nasal breathing and, in two infants, with neck flexion associated with complete upper airway obstruction, suggesting that GG-EMG activity is influenced by sudden changes in upper airway resistance. During sleep, the GG-EMG activity significantly increased with 5% CO2 breathing (P less than or equal to 0.001). With nasal airway occlusion during sleep, the GG-EMG activity increased with the first occluded breath and progressively increased during the subsequent occluded breaths, indicating mechanoreceptor and suggesting chemoreceptor modulation. During nasal occlusion trials, there was a progressive increase in phasic inspiratory activity of the GG-EMG that was greater than that of the diaphragm activity (as reflected by esophageal pressure excursions). When pharyngeal airway closure occurred during a nasal occlusion trial, the negative pressure at which the pharyngeal airway closed (upper airway closing pressure) correlated with the GG-EMG activity at the time of closure, suggesting that the GG muscle contributes to maintaining pharyngeal airway patency in the micrognathic infant.

Respiratory timing during NREM sleep in patients with occlusive sleep apnea

1986 ◽  
Vol 61 (4) ◽  
pp. 1444-1448 ◽  
Author(s):  
E. Onal ◽  
M. Lopata
Keyword(s):  
Sleep Apnea ◽  
Eye Movement ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Afferent Input ◽  
Curvilinear Relationship ◽  
Neural Drive ◽  
Airway Occlusion ◽  
Timing Mechanisms ◽  
The Right

To study respiratory timing mechanisms in patients with occlusive apnea, inspiratory and expiratory times (TI and TE) were calculated from the diaphragmatic electromyogram obtained in seven patients during non-rapid-eye-movement (NREM) sleep. Peak diaphragmatic activity (EMGdi) had a curvilinear relationship with TI during the ventilatory and occlusive phases such that TI shortened as EMGdi decreased during the ventilatory phase (r = 0.87, P less than 0.05) and it prolonged as EMGdi increased during the occlusive phase (r = 0.89, P less than 0.02). However, EMGdi vs. TI for the occlusive phase was shifted to the right of that for the ventilatory phase, reflecting the relatively longer TI during upper airway occlusion. TI also had a linear relationship with pleural pressure (r = 0.94, P less than 0.001) that remained unchanged during the ventilatory and occlusive phases such that it prolonged as negative inspiratory pressure increased. These results indicate that respiratory timing is continuously modified in patients with occlusive apnea as inspiratory neural drive fluctuates during NREM sleep and suggest that this modification is due to the net effects of changing inspiratory neural drive and afferent input predominantly from upper airway mechanoreceptors.

Specificity of esophageal electrode recordings of posterior cricoarytenoid muscle activity

1989 ◽  
Vol 66 (3) ◽  
pp. 1501-1505 ◽  
Author(s):  
G. Insalaco ◽  
G. Sant'Ambrogio ◽  
F. B. Sant'Ambrogio ◽  
S. T. Kuna ◽  
O. P. Mathew
Keyword(s):  
Marked Decrease ◽  
Upper Airway ◽  
Emg Activity ◽  
Small Reduction ◽  
Posterior Cricoarytenoid Muscle ◽  
Intramuscular Electrodes ◽  
Inspiratory Activity ◽  
Recorded Activity ◽  
Posterior Cricoarytenoid ◽  
The Right

Esophageal electrodes have been used for recording the electromyographic (EMG) activity of the posterior cricoarytenoid muscle (PCA). To determine the specificity of this EMG technique, esophageal electrode recordings were compared with intramuscular recordings in eight anesthetized mongrel dogs. Intramuscular wire electrodes were placed in the right and left PCA, and the esophageal electrode was introduced through the nose or mouth and advanced into the upper esophagus. On direct visualization of the upper airway, the unshielded catheter electrode entered the esophagus on the right or left side. Cold block of the recurrent laryngeal nerve (RLN) ipsilateral to the esophageal electrode was associated with a marked decrease in recorded activity, whereas cold block of the contralateral RLN resulted only in a small reduction in activity. After supplemental doses of anesthesia were administered, bilateral RLN cold block essentially abolished the activity recorded with the intramuscular electrodes as well as that recorded with the esophageal electrode. Before supplemental doses of anesthesia were given, especially after vagotomy, the esophageal electrode, and in some cases the intramuscular electrodes, recorded phasic inspiratory activity not originating from the PCA. Therefore, one should be cautious in interpreting the activity recorded from esophageal electrodes as originating from the PCA, especially in conditions associated with increased respiratory efforts.

Alae nasi activation and nasal resistance in healthy subjects

1982 ◽  
Vol 52 (6) ◽  
pp. 1432-1437 ◽  
Author(s):  
K. P. Strohl ◽  
C. F. O'Cain ◽  
A. S. Slutsky
Keyword(s):  
Healthy Subjects ◽  
Airway Resistance ◽  
Upper Airway ◽  
Emg Activity ◽  
Nasal Resistance ◽  
Body Plethysmography ◽  
Surface Electrodes ◽  
Upper Airway Resistance

To investigate the effect of alae nasi (AN) activation on nasal resistance, we monitored AN electromyographic (EMG) activity in 17 healthy subjects using surface electrodes placed on either side of the external nares and measured inspiratory nasal resistance utilizing the method of posterior rhinometry. With CO2 inhalation (6 subj), AN EMG activity increased as nasal resistance fell 23 +/- 5% (P less than 0.01). In the same subjects, voluntary flaring of the external nares also increased AN EMG and decreased nasal resistance by 29 +/- 5% (P less than 0.01). Nasal resistance was altered by nasal flaring and CO2 inhalation even after administration of a topical nasal vasoconstrictive spray (8 subj). In six subjects, voluntary nasal flaring or inhibition with the mouth closed produced a 21 +/- 12% change (P less than 0.01) in total airway resistance as measured by body plethysmography. We conclude that activation of the alae nasi will decrease nasal and total airway resistance during voluntary nasal flaring and during CO2 inhalation and thus should be considered in any studies of upper airway resistance.

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 Modulation of laryngeal and respiratory pump muscle activities with upper airway pressure and flow

2001 ◽  
Vol 91 (2) ◽  
pp. 897-904 ◽  
Author(s):  
M. H. Stella ◽  
S. J. England
Keyword(s):  
Negative Pressure ◽  
Muscle Activity ◽  
Upper Airway ◽  
Abdominal Muscle ◽  
Positive Pressure ◽  
Emg Activity ◽  
Posterior Cricoarytenoid ◽  
Spontaneously Breathing ◽  
Respiratory Muscle Activity ◽  
Stimulation Of

The hypothesis that upper airway (UA) pressure and flow modulate respiratory muscle activity in a respiratory phase-specific fashion was assessed in anesthetized, tracheotomized, spontaneously breathing piglets. We generated negative pressure and inspiratory flow in phase with tracheal inspiration or positive pressure and expiratory flow in phase with tracheal expiration in the isolated UA. Stimulation of UA negative pressure receptors with body temperature air resulted in a 10–15% enhancement of phasic moving-time-averaged posterior cricoarytenoid electromyographic (EMG) activity above tonic levels obtained without pressure and flow in the UA (baseline). Stimulation of UA positive pressure receptors increased phasic moving-time-averaged thyroarytenoid EMG activity above tonic levels by 45% from baseline. The same enhancement of posterior cricoarytenoid or thyroarytenoid EMG activity was observed with the addition of flow receptor stimulation with room temperature air. Tidal volume and diaphragmatic and abdominal muscle activity were unaffected by UA flow and/or pressure, whereas respiratory timing was minimally affected. We conclude that laryngeal afferents, mainly from pressure receptors, are important in modulating the respiratory activity of laryngeal muscles.

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