Diaphragm inhibition with positive pressure ventilation: quantification of mechanical effects
To quantify any mechanical inhibitory effect of nasal intermittent positive pressure ventilation (IPPV) on inspiratory activity of the diaphragm we ventilated five conscious relaxed subjects on two occasions at respiratory rates similar to quiet breathing (QB) and at three levels of applied pressure...
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| Veröffentlicht in: | Respiration physiology 1999-12, Vol.118 (2), p.149-161 |
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| creator | Lake, Fiona R. Finucane, Kevin E. Hillman, David R. |
| description | To quantify any mechanical inhibitory effect of nasal intermittent positive pressure ventilation (IPPV) on inspiratory activity of the diaphragm we ventilated five conscious relaxed subjects on two occasions at respiratory rates similar to quiet breathing (QB) and at three levels of applied pressure (Pappl) — 6, 9 and 12 cmH
2O, each during hypocapnia (P
CO
2
allowed to decrease) and eucapnia (CO
2 added to inspired gas). Diaphragm activity was assessed from transdiaphragmatic pressure (esophageal and gastric balloons) and diaphragm EMG (surface electrodes) both integrated with time (∫Pdi·dt and ∫EMGdi·dt, respectively). Neural inspiratory time (Tin) was measured as onset to peak of the ∫EMGdi·dt signal. Relative to QB, ∫Pdi·dt was 50–69% less during eucapnic IPPV 6–12 cmH
2O (
P |
| doi_str_mv | 10.1016/S0034-5687(99)00065-1 |
| format | Article |
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2O, each during hypocapnia (P
CO
2
allowed to decrease) and eucapnia (CO
2 added to inspired gas). Diaphragm activity was assessed from transdiaphragmatic pressure (esophageal and gastric balloons) and diaphragm EMG (surface electrodes) both integrated with time (∫Pdi·dt and ∫EMGdi·dt, respectively). Neural inspiratory time (Tin) was measured as onset to peak of the ∫EMGdi·dt signal. Relative to QB, ∫Pdi·dt was 50–69% less during eucapnic IPPV 6–12 cmH
2O (
P<0.005) and 67–85% less during hypocapnic IPPV (
P<0.005). Tin decreased (
P<0.05) with IPPV and, on ceasing IPPV, there was apnoea (prolonged expiratory time) on 23 of 27 occasions; these changes were independent of P
CO
2
. ∫EMGdi·dt decreased (
P<0.05) at Pappl 12 cmH
2O during eucapnia and at all Pappl during hypocapnia. The repeatability of ∫EMGdi·dt. was substantially less than ∫Pdi·dt (
F=42,
P≪0.01). We conclude that, during non-invasive IPPV in awake healthy subjects mechanical factors are of major importance in inhibiting inspiratory activity of the diaphragm.</description><identifier>ISSN: 0034-5687</identifier><identifier>DOI: 10.1016/S0034-5687(99)00065-1</identifier><identifier>PMID: 10647859</identifier><identifier>CODEN: RSPYAK</identifier><language>eng</language><publisher>Shannon: Elsevier B.V</publisher><subject>Adult ; Biological and medical sciences ; Cardiorespiratory control. Arterial mecano- and chemoreceptor ; Control of breathing, assisted ventilation, diaphragm inhibition ; Diaphragm - physiology ; Diaphragm, see Muscle ; Female ; Forced Expiratory Volume ; Fundamental and applied biological sciences. Psychology ; Humans ; Intermittent Positive-Pressure Ventilation ; Male ; Mammals, humans ; Mechanics of breathing, assisted ventilation ; Muscle, respiratory, diaphragm inhibition ; Pressure, airways, positive intermittent, diaphragm ; Respiration ; Vertebrates: respiratory system</subject><ispartof>Respiration physiology, 1999-12, Vol.118 (2), p.149-161</ispartof><rights>1999 Elsevier Science B.V.</rights><rights>2000 INIST-CNRS</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c419t-fd8f196afb3582841ff27d00d735b956d5ac35fabcda990a1b74570c17ef9d4d3</citedby><cites>FETCH-LOGICAL-c419t-fd8f196afb3582841ff27d00d735b956d5ac35fabcda990a1b74570c17ef9d4d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1238675$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10647859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lake, Fiona R.</creatorcontrib><creatorcontrib>Finucane, Kevin E.</creatorcontrib><creatorcontrib>Hillman, David R.</creatorcontrib><title>Diaphragm inhibition with positive pressure ventilation: quantification of mechanical effects</title><title>Respiration physiology</title><addtitle>Respir Physiol</addtitle><description>To quantify any mechanical inhibitory effect of nasal intermittent positive pressure ventilation (IPPV) on inspiratory activity of the diaphragm we ventilated five conscious relaxed subjects on two occasions at respiratory rates similar to quiet breathing (QB) and at three levels of applied pressure (Pappl) — 6, 9 and 12 cmH
2O, each during hypocapnia (P
CO
2
allowed to decrease) and eucapnia (CO
2 added to inspired gas). Diaphragm activity was assessed from transdiaphragmatic pressure (esophageal and gastric balloons) and diaphragm EMG (surface electrodes) both integrated with time (∫Pdi·dt and ∫EMGdi·dt, respectively). Neural inspiratory time (Tin) was measured as onset to peak of the ∫EMGdi·dt signal. Relative to QB, ∫Pdi·dt was 50–69% less during eucapnic IPPV 6–12 cmH
2O (
P<0.005) and 67–85% less during hypocapnic IPPV (
P<0.005). Tin decreased (
P<0.05) with IPPV and, on ceasing IPPV, there was apnoea (prolonged expiratory time) on 23 of 27 occasions; these changes were independent of P
CO
2
. ∫EMGdi·dt decreased (
P<0.05) at Pappl 12 cmH
2O during eucapnia and at all Pappl during hypocapnia. The repeatability of ∫EMGdi·dt. was substantially less than ∫Pdi·dt (
F=42,
P≪0.01). We conclude that, during non-invasive IPPV in awake healthy subjects mechanical factors are of major importance in inhibiting inspiratory activity of the diaphragm.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiorespiratory control. Arterial mecano- and chemoreceptor</subject><subject>Control of breathing, assisted ventilation, diaphragm inhibition</subject><subject>Diaphragm - physiology</subject><subject>Diaphragm, see Muscle</subject><subject>Female</subject><subject>Forced Expiratory Volume</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Intermittent Positive-Pressure Ventilation</subject><subject>Male</subject><subject>Mammals, humans</subject><subject>Mechanics of breathing, assisted ventilation</subject><subject>Muscle, respiratory, diaphragm inhibition</subject><subject>Pressure, airways, positive intermittent, diaphragm</subject><subject>Respiration</subject><subject>Vertebrates: respiratory system</subject><issn>0034-5687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v3CAQhjk0ym43_QmtOFRRc3ACtgGTS1RtPqWVemh7rBCGoUvlr4C9Uf592A8lveU0eodnZtCD0GdKzimh_OInIUWZMV6Jb1KeEUI4y-gHNH9tz9DHGP-lh4ITfoxmlPBSVEzO0Z9rr4d10H9b7Lu1r_3o-w4_-XGNhz6mtAE8BIhxCoA30I2-0VvkEj9OOiXnzS7j3uEWzFp3qdFgcA7MGE_QkdNNhE-HukC_b29-Le-z1Y-7h-X3VWZKKsfM2cpRybWrC1blVUmdy4UlxIqC1ZJxy7QpmNO1sVpKomktSiaIoQKctKUtFuh0v3cI_eMEcVStjwaaRnfQT1FxWVLBcp5AtgdN6GMM4NQQfKvDs6JEbV2qnUu1laakVDuXiqa5L4cDU92C_W9qLzIBXw-AjkmAC7ozPr5xeVFxwRJ2tccg2dh4CCoaD50B60MSpmzv3_nJC3EilN4</recordid><startdate>19991201</startdate><enddate>19991201</enddate><creator>Lake, Fiona R.</creator><creator>Finucane, Kevin E.</creator><creator>Hillman, David R.</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>19991201</creationdate><title>Diaphragm inhibition with positive pressure ventilation: quantification of mechanical effects</title><author>Lake, Fiona R. ; Finucane, Kevin E. ; Hillman, David R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c419t-fd8f196afb3582841ff27d00d735b956d5ac35fabcda990a1b74570c17ef9d4d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiorespiratory control. Arterial mecano- and chemoreceptor</topic><topic>Control of breathing, assisted ventilation, diaphragm inhibition</topic><topic>Diaphragm - physiology</topic><topic>Diaphragm, see Muscle</topic><topic>Female</topic><topic>Forced Expiratory Volume</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Intermittent Positive-Pressure Ventilation</topic><topic>Male</topic><topic>Mammals, humans</topic><topic>Mechanics of breathing, assisted ventilation</topic><topic>Muscle, respiratory, diaphragm inhibition</topic><topic>Pressure, airways, positive intermittent, diaphragm</topic><topic>Respiration</topic><topic>Vertebrates: respiratory system</topic><toplevel>online_resources</toplevel><creatorcontrib>Lake, Fiona R.</creatorcontrib><creatorcontrib>Finucane, Kevin E.</creatorcontrib><creatorcontrib>Hillman, David R.</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>Respiration physiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lake, Fiona R.</au><au>Finucane, Kevin E.</au><au>Hillman, David R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diaphragm inhibition with positive pressure ventilation: quantification of mechanical effects</atitle><jtitle>Respiration physiology</jtitle><addtitle>Respir Physiol</addtitle><date>1999-12-01</date><risdate>1999</risdate><volume>118</volume><issue>2</issue><spage>149</spage><epage>161</epage><pages>149-161</pages><issn>0034-5687</issn><coden>RSPYAK</coden><abstract>To quantify any mechanical inhibitory effect of nasal intermittent positive pressure ventilation (IPPV) on inspiratory activity of the diaphragm we ventilated five conscious relaxed subjects on two occasions at respiratory rates similar to quiet breathing (QB) and at three levels of applied pressure (Pappl) — 6, 9 and 12 cmH
2O, each during hypocapnia (P
CO
2
allowed to decrease) and eucapnia (CO
2 added to inspired gas). Diaphragm activity was assessed from transdiaphragmatic pressure (esophageal and gastric balloons) and diaphragm EMG (surface electrodes) both integrated with time (∫Pdi·dt and ∫EMGdi·dt, respectively). Neural inspiratory time (Tin) was measured as onset to peak of the ∫EMGdi·dt signal. Relative to QB, ∫Pdi·dt was 50–69% less during eucapnic IPPV 6–12 cmH
2O (
P<0.005) and 67–85% less during hypocapnic IPPV (
P<0.005). Tin decreased (
P<0.05) with IPPV and, on ceasing IPPV, there was apnoea (prolonged expiratory time) on 23 of 27 occasions; these changes were independent of P
CO
2
. ∫EMGdi·dt decreased (
P<0.05) at Pappl 12 cmH
2O during eucapnia and at all Pappl during hypocapnia. The repeatability of ∫EMGdi·dt. was substantially less than ∫Pdi·dt (
F=42,
P≪0.01). We conclude that, during non-invasive IPPV in awake healthy subjects mechanical factors are of major importance in inhibiting inspiratory activity of the diaphragm.</abstract><cop>Shannon</cop><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>10647859</pmid><doi>10.1016/S0034-5687(99)00065-1</doi><tpages>13</tpages></addata></record> |
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| subjects | Adult Biological and medical sciences Cardiorespiratory control. Arterial mecano- and chemoreceptor Control of breathing, assisted ventilation, diaphragm inhibition Diaphragm - physiology Diaphragm, see Muscle Female Forced Expiratory Volume Fundamental and applied biological sciences. Psychology Humans Intermittent Positive-Pressure Ventilation Male Mammals, humans Mechanics of breathing, assisted ventilation Muscle, respiratory, diaphragm inhibition Pressure, airways, positive intermittent, diaphragm Respiration Vertebrates: respiratory system |
| title | Diaphragm inhibition with positive pressure ventilation: quantification of mechanical effects |
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