INSPIRATORY MUSCLE INTERACTION IN THE GENERATION OF CHANGES IN AIRWAY PRESSURE
INSPIRATORY MUSCLE INTERACTION IN THE GENERATION OF CHANGES IN AIRWAY PRESSURE
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DOI：
10.1152/jappl.1989.66.6.2573
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发表时间：
1989-06-01
影响因子：
3.3
通讯作者：
BUDZINSKA, K
中科院分区：
文献类型：
--
作者：
DIMARCO, AF;SUPINSKI, GS;BUDZINSKA, K
吸气肌在气道压力变化中的机械相互作用尚不清楚。使用上胸脊髓刺激来激活肋间肌 (IC) 和双侧超最大膈神经刺激来激活膈肌 (D)，我们测量了在大范围肺容积内单独和组合 IC 和 D 激活所产生的气道压力变化。通过声测法评估胸骨旁 IC 和 D 长度的变化。随着肺容量的增加，IC 和 D 的激活导致产生的气道压力逐渐减少。 IC 和 D 收缩相结合产生的气道压力负波动比单独 IC 和 D 收缩的算术总和更大，表明存在协同效应。此外，随着肺容量的增加，协同作用逐渐增强。在联合肌肉收缩期间，IC 和 D 的缩短程度均小于任一肌群单独收缩期间的缩短程度。在 D 收缩期间，对于给定的气道压力变化，胸骨旁肌肉延长的趋势随着肺容量的增加而增加，这表明胸腔向内反冲的趋势随着肺容量的增加而逐渐增加。同样，仅在 IC 收缩期间，对于给定的气道压力变化，D 延长的趋势也随着肺容量的增加而逐渐增加，这表明腹部 D 室向内反冲的趋势也随着肺容量的增加而增加。我们得出结论，IC 和 D 协同相互作用，产生气道压力的变化。我们的结果表明，这种效应可能是继发于 1）联合肌肉收缩期间发生的肌肉缩短的减少和/或 2）IC 和 D 联合激活对胸壁稳定性的重要性。
The mechanical interaction of the inspiratory muscles in the generation of changes in airway pressure is unclear. Using upper thoracic spinal cord stimulation to activate the intercostal muscles (IC) and bilateral supramaximal phrenic nerve stimulation to activate the diaphragm (D), we measured the changes in airway pressure produced by separate and combined IC and D activation over a wide range of lung volumes. Changes in parasternal IC and D length were assessed by sonomicrometry. With increasing lung volume, activation of the IC and D resulted in progressive decrements in generated airway pressure. Combined IC and D contraction produced greater negative swings in airway pressure than the arithmetic sum of separate IC and D contraction alone, indicating a synergistic effect. Moreover, synergism increased progressively with increasing lung volume. During combined muscle contraction, both the IC and D shortened less than during contraction of either muscle group alone. The tendency for the parasternal muscle to lengthen for a given change in airway pressure during D contraction alone increased with increasing lung volume, suggesting that the tendency for the rib cage to recoil inward increased progressively with increasing lung volume. Likewise, the tendency of the D to lengthen for a given change in airway pressure during IC contraction alone also increased progressively with increasing lung volume, suggesting that the tendency for the abdomen-D compartment to recoil inward also increased with increasing lung volume. We conclude that the IC and D interact synergistically to produce changes in airway pressure. Our results suggest that this effect may be secondary to 1) the reduction in muscle shortening that occurs during combined muscle contraction and/or 2) the importance of combined IC and D activation on chest wall stability.