Altered diaphragm contractile properties with controlled mechanical ventilation
Altered diaphragm contractile properties with controlled mechanical ventilation
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DOI：
10.1152/japplphysiol.01213.2001
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发表时间：
2002-06-01
影响因子：
3.3
通讯作者：
Sieck, GC
中科院分区：
文献类型：
--
作者：
Sassoon, CSH;Caiozzo, VJ;Sieck, GC
这项研究表明，随着时间的推移，在受控机械通气(CMV)下，横隔肌不活动会降低横隔力，并产生肌原纤维损伤，从而导致力量减少。我们测定了30只镇静组(n=6)在体和体外的横隔膜收缩和形态特征：CMV 1~3天，CMH(2)O持续正压1~3天，对照组。设定的CMV速率足以抑制隔膜的电活动。与对照组相比，持续正压下，膈刺激最大跨膈压无明显下降，但在CMV后第1天下降到63%，在CMV后第3天下降到49%。体外破伤力在CMV感染1天后下降到86%，在CMV感染后3天下降到44%。CMV后3天，肌原纤维明显受损，但比目鱼肌未见明显损伤。强直力的降低与异常肌原纤维的体积密度相关。我们得出结论，巨细胞病毒对横隔膜的收缩特性有不利影响。
This study shows that, over time, diaphragm inactivity with controlled mechanical ventilation (CMV) decreases diaphragm force and produces myofibril damage contributing to the reduced force. We measured in vivo and in vitro diaphragm contractile and morphological properties in 30 sedated rabbits grouped (n = 6) as follows: 1 or 3 days of CMV, 1 or 3 days of 0 cmH(2)O continuous positive airway pressure, and control. The CMV rate was set sufficient to suppress diaphragm electrical activity. Compared with the control group, phrenic-stimulated maximum transdiaphragmatic pressure did not decrease with continuous positive airway pressure but decreased to 63% after 1 day of CMV and to 49% after 3 days of CMV. The in vitro tetanic force decreased to 86% after 1 day of CMV and to 44% after 3 days of CMV. After 3 days of CMV, significant myofibril damage occurred in the diaphragm but not in the soleus. The decrease in tetanic force correlated with the volume density of abnormal myofibrils. We conclude that CMV had a detrimental effect on diaphragm contractile properties.