Function of respiratory muscles during partial curarization in humans.
Function of respiratory muscles during partial curarization in humans.
复制标题
人类部分箭毒化过程中呼吸肌的功能。
DOI：
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
L. Delhez
中科院分区：
文献类型：
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作者：
A. De Troyer;J. Bastenier;L. Delhez
在4名缓慢输注泮库溴铵的健康男性中，研究了亚极量神经肌肉阻滞（SMNB）对不同类型呼吸动作时呼吸肌复张（或去复张）的影响。对肺力学的影响与之前观察到的相似，即吸气期间肺回缩压力没有变化，而胸壁压力-容积（PV）曲线向右移动（Rahn图）。在每例受试者中，在吸气期间，在任何给定的肺容量下，SMNB均导致腹部（胃）和经腹压力大幅增加，反映了呼吸压力波动的更大的呼吸贡献。此外，使用同心针电极，我们观察到SMNB期间腹部和肋间/副肌的电（强直性和相位性）活动显著下降，但肌肉活动略有增加。随着通气量的增加，这种变化模式加重。这些结果表明，与人体其他呼吸肌相比，膈肌对箭毒的抵抗力更强，SMNB期间胸壁PV曲线的转位与肋间肌肉组织的紧张性活动丧失有关。膈肌和其他呼吸肌对箭毒敏感性的差异可能与神经肌肉突触安全界限的差异有关。
The effects of submaximal neuromuscular blockade (SMNB) on the recruitment (or derecruitment) of the respiratory muscles during different types of respiratory maneuvers were studied in four healthy males infused slowly with pancuronium. The effects on lung mechanics were similar to those observed previously in that lung recoil pressure during inspiration did not change while the chest wall pressure-volume (PV) curve was shifted to the right (Rahn diagram). In each subject, SMNB produced a large increase in abdominal (gastric) and transdiaphragmatic pressures at any given lung volume during inspiration, reflecting greater diaphragmatic contribution to respiratory pressure swings. In addition, using concentric needle electrodes, we observed a marked fall in electrical (tonic and phasic) activity in the abdominal and in the intercostal/accessory muscles during SMNB but a slight increase in diaphragmatic activity. This pattern of changes was accentuated as ventilation increased. These findings indicate that the diaphragm is more resistant to curare than the other respiratory muscles in humans and that the transposition of the chest wall PV curve during SMNB is related to a loss of tonic activity in the intercostal musculature. The difference in sensitivity toward curare between the diaphragm and the other respiratory muscles is probably related to a difference in the safety margin at the neuromuscular synapses.