ACTIVATION OF THE INSPIRATORY INTERCOSTAL MUSCLES BY ELECTRICAL-STIMULATION OF THE SPINAL-CORD
ACTIVATION OF THE INSPIRATORY INTERCOSTAL MUSCLES BY ELECTRICAL-STIMULATION OF THE SPINAL-CORD
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DOI：
10.1164/ajrccm/136.6.1385
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发表时间：
1987-12-01
期刊：
影响因子：
--
通讯作者：
DURAND, D
中科院分区：
文献类型：
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作者：
DIMARCO, AF;ALTOSE, MD;DURAND, D
脊髓的电刺激被评价为激活吸气肋间肌的方法。在过度通气诱导的呼吸暂停后的麻醉犬中进行研究。将不锈钢电极沿着其整个长度（除了远端头端的2 - 3 mm）涂上橡胶，经尿道插入胸脊髓背侧表面。刺激电极也被放置在每个半横膈膜。监测肋间肌电图、吸气量和胸腹运动。每只动物的吸气量确定为在被动肺充气期间达到+25 cm H2O的气道压力所需的体积。在T2-T3脊髓水平的脊髓刺激导致最大吸气量产生和电激活的胸骨旁，外部和内部肋间肌肉的上部和中脉笼区域，如肌电图所确定的。胸内压力波动随着刺激幅度和频率的增加而逐渐增加，直到分别在6 mA和40 Hz时达到平台。膈神经切开术后脊髓刺激导致胸腔扩张和腹腔室周长减少。脊髓刺激期间的吸气量为537 ± 0.01。49 ml（膈前切开术，俯卧位），347 . ±. 19.6 ml（膈神经切开术后，俯卧位），和303 ±. 30.6 ml（膈切开术后，仰卧位）。单独双侧膈肌激活导致404 ± 0.001的吸入量。39毫升。膈肌和膈神经切开术后脊髓刺激（仰卧）的组合导致712 ± 0.5ml的吸入量。72 ml，接近吸气容量（803 . ±. 35 ml）。我们的研究结果表明，脊髓刺激可能是一个有用的生理和临床工具，产生协调收缩的吸气肋间肌肉。
Electrical stimulation of the spinal cord was evaluated as a method of activating the inspiratory intercostal muscles. Studies were performed in anesthetized dogs after hyperventilation-induced apnea. A stainless steel electrode, rubberized along its entire length except for 2 to 3 mm at the distal tip, was introduced epidurally onto the dorsal surface of the thoracic spinal cord. Stimulating electrodes were also placed in each hemidiaphragm. Intercostal electromyograms, inspired volume, and thoracoabdominal movements were monitored. The inspiratory capacity was determined in each animal as the volume required to achieve an airway pressure of +25 cm H2O during passive lung inflation. Spinal cord stimulation at the T2-T3 spinal level resulted in maximal inspired volume generation and electrical activation of the parasternal, external, and internal intercostal muscles of the upper and midrib cage regions as determined by electromyograms. Intrathoracic pressure swings increased progressively with increasing stimulus amplitude and frequency until plateaus were reached at 6 mA and 40 Hz, respectively. Postphrenicotomy spinal cord stimulation resulted in expansion of the rib cage and reduction in circumference of the abdominal compartment. Inspired volumes during spinal cord stimulation were 537 .+-. 49 ml (prephrenicotomy, prone), 347 .+-. 19.6 ml (postphrenicotomy, prone), and 303 .+-. 30.6 ml (postphrenicotomy, supine). Bilateral diaphragm activation alone resulted in inspired volumes of 404 .+-. 39 ml. Combined diaphragm and postphrenicotomy spinal cord stimulation (supine) resulted in an inspired volume of 712 .+-. 72 ml, which approximated the inspiratory capacity (803 .+-. 35 ml). Our results suggest that spinal cord stimulation may be a useful physiologic and clinical tool to produce coordinated contraction of the inspiratory intercostal muscles.