RESPIRATORY CONTROL OF THE ALAE NASI IN PRETERM INFANTS

早产儿 ALAE NSI 的呼吸控制

• 批准号: 3448570
• 负责人: WALDEMAR A. CARLO FONT
• 金额: $ 5.55万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1983
• 资助国家: 美国
• 起止时间: 1983-07-01 至 1986-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3448570
• 关键词: chemoreceptors; electromyography; human subject; hypoxia neonatorum; mechanoreceptors; premature infant human; respiratory airflow disorder; respiratory airflow measurement; respiratory airway pressure; respiratory distress syndrome of newborn; respiratory muscles; stretch receptors

The alae nasi (AN) has been identified as a respiratory muscle of the upper airway that is able to alter nasal resistance and modify airflow to the lungs. Neonates and obligate nose breathers and frequently have spontaneous AN activity (nasal flaring) especially in the first hours of life, during feeding, and as a major clinical sign of respiratory distress. We have shown that AN activation is enhanced during active as compared to quiet sleep, has its onset and peak of activity prior to that of the diaphragm (DIA), and causes a reduction in nasal resistance and consequent decrease in negative pharyngeal pressure during inspiration. As the AN may influence work of breathing and airway patency in newborn infants, it is important to understand the chemical and mechanoreceptor control of this muscle in comparison to that of the DIA. We plan to alter chemosensitivity using brief periods of hypoxemia or hyperoxia alone or in combination with hypercapnia to determine the relative roles of these chemical stimuli on the control of AN and DIA activity. We will alter the level of mechanoreceptor stimulation by means of continuous positive airway pressure and airway occlusion to define the role of stretch receptors in modifying AN activity. The latter studies will be additionally performed both prior to and following extubation to determine the relative roles of receptors in the upper and lower airway. We will characterize the physiologic mechanics underlying the AN activity observed during both non-nutritive sucking and oral feeding. In all these studies, AN activity will be compared to that of the DIA to determine their relative responses to the range of various stimuli. An understanding of the factors that trigger AN activation will allow us to infer the physiologic processes underlying spontaneous nasal flaring in infants. Since numerous respiratory muscles of the upper airway appear to exhibit similar responses to certain stimuli, unstable AN activity might reflect a generalized derangement involving other upper airway muscles. The ready accessibility of the AN to both clinical observations and physiologic measurements could reveal abnormalities in the neuromuscular control of the upper airway in neonates at risk for obstructive apneic episodes.

鼻翼 (AN) 已被确定为上呼吸道的呼吸肌 能够改变鼻阻力并改变通向鼻腔的气流的气道 肺。 新生儿和用鼻子呼吸的人经常有 自发性 AN 活动（鼻翼煽动），尤其是在入睡的最初几个小时 生活、喂养期间以及作为呼吸系统疾病的主要临床症状 苦恼。 我们已经证明，AN 激活在活跃期间得到增强 与安静的睡眠相比，其活动的开始和高峰期早于安静的睡眠 隔膜（DIA），并导致鼻阻力减少和 吸气期间咽负压随之降低。 作为 AN 可能会影响新生儿的呼吸功能和气道通畅 对于婴儿，了解化学和机械感受器很重要 与 DIA 相比，该肌肉的控制能力。 我们计划改变 单独使用短暂的低氧血症或高氧血症或联合使用时的化学敏感性 与高碳酸血症结合以确定这些因素的相对作用 化学刺激对 AN 和 DIA 活性的控制。 我们将改变 通过持续正压气道刺激机械感受器的水平 压力和气道阻塞来定义牵张感受器的作用 修改 AN 活动。 后面的研究将另外进行 在拔管之前和之后确定相关作用 上呼吸道和下呼吸道的受体。 我们将表征 期间观察到的 AN 活动的生理力学 非营养性吸吮和经口喂养。 在所有这些研究中，AN 活动 将与 DIA 进行比较以确定它们的相对响应 到各种刺激的范围。 对影响因素的理解 触发 AN 激活将使我们能够推断生理过程 婴儿潜在的自发性鼻翼煽动。 由于无数 上呼吸道的呼吸肌似乎表现出类似的反应 对于某些刺激，不稳定的 AN 活动可能反映了普遍的 涉及其他上呼吸道肌肉的紊乱。 准备就绪的可达性 AN 对临床观察和生理测量的影响 揭示上呼吸道神经肌肉控制的异常 有阻塞性呼吸暂停发作风险的新生儿。