Continuous positive airway pressure reduces loop gain and resolves periodic central apneas in the lamb
Abstract Continous positive airway pressure (CPAP) is used to treat infant respiratory distress syndrome and apnea of prematurity, but its mode of action is not fully understood. We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experime...
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| Veröffentlicht in: | Respiratory physiology & neurobiology 2009-09, Vol.168 (3), p.239-249 |
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| creator | Edwards, Bradley A Sands, Scott A Feeney, Clare Skuza, Elizabeth M Brodecky, Vojta Wilkinson, Malcolm H Berger, Philip J |
| description | Abstract Continous positive airway pressure (CPAP) is used to treat infant respiratory distress syndrome and apnea of prematurity, but its mode of action is not fully understood. We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experimentally induced periodic breathing (PB) in the lamb was terminated early by CPAP in a dose-dependent manner, with a control epoch of 45.4 ± 5.1 s at zero CPAP falling to 32.9 ± 5.4, 13.2 ± 4.2 and 9.8 ± 3.1 s at 2.5, 5 and 10 cmH2 O, respectively ( p < 0.001); corresponding duty ratios (duration of the ventilatory phase of PB divided by its cycle duration) increased from 0.50 ± 0.02 to 0.62 ± 0.05, 0.76 ± 0.06 and 0.68 ± 0.08, respectively ( p < 0.001). Since epoch duration and duty ratio are surrogate measures of LG, we conclude that CPAP ameliorates the effects of recurrent central apneas, and perhaps mixed and obstructive apneas, by decreasing LG via increases in lung volume. |
| doi_str_mv | 10.1016/j.resp.2009.07.006 |
| format | Article |
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We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experimentally induced periodic breathing (PB) in the lamb was terminated early by CPAP in a dose-dependent manner, with a control epoch of 45.4 ± 5.1 s at zero CPAP falling to 32.9 ± 5.4, 13.2 ± 4.2 and 9.8 ± 3.1 s at 2.5, 5 and 10 cmH2 O, respectively ( p < 0.001); corresponding duty ratios (duration of the ventilatory phase of PB divided by its cycle duration) increased from 0.50 ± 0.02 to 0.62 ± 0.05, 0.76 ± 0.06 and 0.68 ± 0.08, respectively ( p < 0.001). Since epoch duration and duty ratio are surrogate measures of LG, we conclude that CPAP ameliorates the effects of recurrent central apneas, and perhaps mixed and obstructive apneas, by decreasing LG via increases in lung volume.</description><identifier>ISSN: 1569-9048</identifier><identifier>EISSN: 1878-1519</identifier><identifier>DOI: 10.1016/j.resp.2009.07.006</identifier><identifier>PMID: 19616133</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Analysis of Variance ; Animals ; Animals, Newborn ; Biological and medical sciences ; Continuous Positive Airway Pressure - methods ; CPAP ; Disease Models, Animal ; Fundamental and applied biological sciences. Psychology ; Loop gain ; Medical Education ; Periodic breathing ; Polysomnography - methods ; Predictive Value of Tests ; Pulmonary Ventilation - physiology ; Pulmonary/Respiratory ; Respiratory Mechanics ; Sheep ; Sleep Apnea, Central - physiopathology ; Sleep Apnea, Central - therapy ; Tidal Volume - physiology ; Vertebrates: respiratory system</subject><ispartof>Respiratory physiology & neurobiology, 2009-09, Vol.168 (3), p.239-249</ispartof><rights>Elsevier B.V.</rights><rights>2009 Elsevier B.V.</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-63616e067ee4113e9f47284488e9f4eb43bf659a93cdf38f72877e273b01d9e53</citedby><cites>FETCH-LOGICAL-c439t-63616e067ee4113e9f47284488e9f4eb43bf659a93cdf38f72877e273b01d9e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1569904809001888$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21959242$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19616133$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Edwards, Bradley A</creatorcontrib><creatorcontrib>Sands, Scott A</creatorcontrib><creatorcontrib>Feeney, Clare</creatorcontrib><creatorcontrib>Skuza, Elizabeth M</creatorcontrib><creatorcontrib>Brodecky, Vojta</creatorcontrib><creatorcontrib>Wilkinson, Malcolm H</creatorcontrib><creatorcontrib>Berger, Philip J</creatorcontrib><title>Continuous positive airway pressure reduces loop gain and resolves periodic central apneas in the lamb</title><title>Respiratory physiology & neurobiology</title><addtitle>Respir Physiol Neurobiol</addtitle><description>Abstract Continous positive airway pressure (CPAP) is used to treat infant respiratory distress syndrome and apnea of prematurity, but its mode of action is not fully understood. We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experimentally induced periodic breathing (PB) in the lamb was terminated early by CPAP in a dose-dependent manner, with a control epoch of 45.4 ± 5.1 s at zero CPAP falling to 32.9 ± 5.4, 13.2 ± 4.2 and 9.8 ± 3.1 s at 2.5, 5 and 10 cmH2 O, respectively ( p < 0.001); corresponding duty ratios (duration of the ventilatory phase of PB divided by its cycle duration) increased from 0.50 ± 0.02 to 0.62 ± 0.05, 0.76 ± 0.06 and 0.68 ± 0.08, respectively ( p < 0.001). Since epoch duration and duty ratio are surrogate measures of LG, we conclude that CPAP ameliorates the effects of recurrent central apneas, and perhaps mixed and obstructive apneas, by decreasing LG via increases in lung volume.</description><subject>Analysis of Variance</subject><subject>Animals</subject><subject>Animals, Newborn</subject><subject>Biological and medical sciences</subject><subject>Continuous Positive Airway Pressure - methods</subject><subject>CPAP</subject><subject>Disease Models, Animal</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Loop gain</subject><subject>Medical Education</subject><subject>Periodic breathing</subject><subject>Polysomnography - methods</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary Ventilation - physiology</subject><subject>Pulmonary/Respiratory</subject><subject>Respiratory Mechanics</subject><subject>Sheep</subject><subject>Sleep Apnea, Central - physiopathology</subject><subject>Sleep Apnea, Central - therapy</subject><subject>Tidal Volume - physiology</subject><subject>Vertebrates: respiratory system</subject><issn>1569-9048</issn><issn>1878-1519</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks-r1DAQgIMovufTf8CD5KK31qRp8wNEkEWfwgMP6jmk6VSzdpOaaVf2vzdlFx948JRh8s1k8jGEPOes5ozL1_s6A851w5ipmaoZkw_INddKV7zj5mGJO2kqw1p9RZ4g7hnjiivxmFxxI7nkQlyTcZfiEuKaVqRzwrCEI1AX8m93onNpj2sGmmFYPSCdUprpdxcidXEoWUzTsaRnyCENwVMPccluom6O4JAWbvkBdHKH_il5NLoJ4dnlvCHfPrz_uvtY3X2-_bR7d1f5VpilkqLMBUwqgJZzAWZsVaPbVusthL4V_Sg744zwwyj0WC6VgkaJnvHBQCduyKtz3zmnXyvgYg8BPUyTi1C-aKWSgjHFCticQZ8TYobRzjkcXD5Zzuxm1-7tZtdudi1TttgtRS8u3df-AMN9yUVnAV5eAIfeTWN20Qf8yzXcdKZpm8K9OXNQXBwDZIs-QPQwhAx-sUMK_5_j7T_lfgoxlBd_wglwn9Yci2XLLTaW2S_bHmxrwExZAa21-APQ4q5L</recordid><startdate>20090930</startdate><enddate>20090930</enddate><creator>Edwards, Bradley A</creator><creator>Sands, Scott A</creator><creator>Feeney, Clare</creator><creator>Skuza, Elizabeth M</creator><creator>Brodecky, Vojta</creator><creator>Wilkinson, Malcolm H</creator><creator>Berger, Philip J</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090930</creationdate><title>Continuous positive airway pressure reduces loop gain and resolves periodic central apneas in the lamb</title><author>Edwards, Bradley A ; Sands, Scott A ; Feeney, Clare ; Skuza, Elizabeth M ; Brodecky, Vojta ; Wilkinson, Malcolm H ; Berger, Philip J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-63616e067ee4113e9f47284488e9f4eb43bf659a93cdf38f72877e273b01d9e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Analysis of Variance</topic><topic>Animals</topic><topic>Animals, Newborn</topic><topic>Biological and medical sciences</topic><topic>Continuous Positive Airway Pressure - methods</topic><topic>CPAP</topic><topic>Disease Models, Animal</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Loop gain</topic><topic>Medical Education</topic><topic>Periodic breathing</topic><topic>Polysomnography - methods</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary Ventilation - physiology</topic><topic>Pulmonary/Respiratory</topic><topic>Respiratory Mechanics</topic><topic>Sheep</topic><topic>Sleep Apnea, Central - physiopathology</topic><topic>Sleep Apnea, Central - therapy</topic><topic>Tidal Volume - physiology</topic><topic>Vertebrates: respiratory system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Edwards, Bradley A</creatorcontrib><creatorcontrib>Sands, Scott A</creatorcontrib><creatorcontrib>Feeney, Clare</creatorcontrib><creatorcontrib>Skuza, Elizabeth M</creatorcontrib><creatorcontrib>Brodecky, Vojta</creatorcontrib><creatorcontrib>Wilkinson, Malcolm H</creatorcontrib><creatorcontrib>Berger, Philip J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory physiology & neurobiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Edwards, Bradley A</au><au>Sands, Scott A</au><au>Feeney, Clare</au><au>Skuza, Elizabeth M</au><au>Brodecky, Vojta</au><au>Wilkinson, Malcolm H</au><au>Berger, Philip J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Continuous positive airway pressure reduces loop gain and resolves periodic central apneas in the lamb</atitle><jtitle>Respiratory physiology & neurobiology</jtitle><addtitle>Respir Physiol Neurobiol</addtitle><date>2009-09-30</date><risdate>2009</risdate><volume>168</volume><issue>3</issue><spage>239</spage><epage>249</epage><pages>239-249</pages><issn>1569-9048</issn><eissn>1878-1519</eissn><abstract>Abstract Continous positive airway pressure (CPAP) is used to treat infant respiratory distress syndrome and apnea of prematurity, but its mode of action is not fully understood. We hypothesised that CPAP increases lung volume and stabilises respiratory control by decreasing loop gain (LG). Experimentally induced periodic breathing (PB) in the lamb was terminated early by CPAP in a dose-dependent manner, with a control epoch of 45.4 ± 5.1 s at zero CPAP falling to 32.9 ± 5.4, 13.2 ± 4.2 and 9.8 ± 3.1 s at 2.5, 5 and 10 cmH2 O, respectively ( p < 0.001); corresponding duty ratios (duration of the ventilatory phase of PB divided by its cycle duration) increased from 0.50 ± 0.02 to 0.62 ± 0.05, 0.76 ± 0.06 and 0.68 ± 0.08, respectively ( p < 0.001). Since epoch duration and duty ratio are surrogate measures of LG, we conclude that CPAP ameliorates the effects of recurrent central apneas, and perhaps mixed and obstructive apneas, by decreasing LG via increases in lung volume.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>19616133</pmid><doi>10.1016/j.resp.2009.07.006</doi><tpages>11</tpages></addata></record> |
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| subjects | Analysis of Variance Animals Animals, Newborn Biological and medical sciences Continuous Positive Airway Pressure - methods CPAP Disease Models, Animal Fundamental and applied biological sciences. Psychology Loop gain Medical Education Periodic breathing Polysomnography - methods Predictive Value of Tests Pulmonary Ventilation - physiology Pulmonary/Respiratory Respiratory Mechanics Sheep Sleep Apnea, Central - physiopathology Sleep Apnea, Central - therapy Tidal Volume - physiology Vertebrates: respiratory system |
| title | Continuous positive airway pressure reduces loop gain and resolves periodic central apneas in the lamb |
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