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Phrenic Nerve and Pulmonary Stretch Receptor Activity during Proportional Assist Ventilation and CPAP: A Study in Surfactant Depleted Cats early after Surfactant Instillation
Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Women's and Children's Health.
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Article in journal (Refereed) Submitted
URN: urn:nbn:se:uu:diva-92394OAI: oai:DiVA.org:uu-92394DiVA: diva2:165449
Available from: 2004-11-15 Created: 2004-11-15Bibliographically approved
In thesis
1. Regulation of Breathing under Different Pulmonary Conditions
Open this publication in new window or tab >>Regulation of Breathing under Different Pulmonary Conditions
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The breathing pattern of preterm infants is immature and is associated with a variety of reflexes. In a patient on the ventilator these reflexes interfere with spontaneous breathing. A better understanding of the immature control of breathing could lead to further improvements in ventilatory techniques. This thesis concerns studies of pulmonary stretch receptor (PSR) and phrenic nerve activity as part of the regulation of breathing in an animal model.

During assist/control ventilation with three different inspiratory pressure waveforms in animals with healthy lungs, squarewave pressure waveform strongly inhibits spontaneous inspiratory activity.

During partial liquid ventilation (PLV) in animals with healthy lungs, all PSRs studied maintained their phasic character, with increased impulse frequency during inspiration. PSR activity was not higher during PLV than during gas ventilation (GV), indicating that there was no extensive stretching of the lung during PLV.

During proportional assist ventilation (PAV) the applied airway pressure is servo-controlled proportionally to the ongoing breathing effort, thereby interacting with the activity of PSRs. Peak PSR activity was higher and occurred earlier during PAV than during CPAP. The regulation of breathing is maintained during PAV in surfactant-depleted animals before and early after surfactant instillation, with a higher ventilatory response and a lower breathing effort than during CPAP in both conditions.

Both lung mechanics and gas exchange influence the regulation of breathing. Inhibition of inspiratory activity occurred at a lower arterial pH and a higher PaCO2 during PLV than during GV in animals with surfactant-depleted lungs, which might be related to recruitment of a larger number of pulmonary stretch receptors during PLV.

In summary, selected aspects of the regulation of breathing were studied in an animal model with different ventilatory techniques under different lung conditions similar to those that can occur in infants.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2004. 40 p.
Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 0282-7476 ; 1390
Pediatrics, Control of breathing, Pulmonary Stretch Receptor, Phrenic Nerve Activity, Respiratory Distress Syndrome, Surfactant, Partial Liquid Ventilation, Assisted Ventilation, Pediatrik
National Category
urn:nbn:se:uu:diva-4671 (URN)91-554-6096-8 (ISBN)
Public defence
2004-12-06, Rosensalen, Children's University Hospital, 751 85, Uppsala, 09:15
Available from: 2004-11-15 Created: 2004-11-15 Last updated: 2013-12-10Bibliographically approved

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