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Tytuł pozycji:

Physiological changes and compensatory mechanisms by the action of respiratory muscles in a porcine model of phrenic nerve injury.

Tytuł :
Physiological changes and compensatory mechanisms by the action of respiratory muscles in a porcine model of phrenic nerve injury.
Autorzy :
LoMauro A; Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.
Aliverti A; Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Italy.
Perchiazzi G; Department of Surgical Sciences, Uppsala University Hospital, Sweden.
Frykholm P; Department of Surgical Sciences, Uppsala University Hospital, Sweden.
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Źródło :
Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2021 Jan 14. Date of Electronic Publication: 2021 Jan 14.
Publication Model :
Ahead of Print
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: Bethesda, MD : American Physiological Society, c1985-
Contributed Indexing :
Keywords: breathing asynchrony; diaphragmatic paralysis; phrenic nerve injury; pressure support; ribcage muscles
Entry Date(s) :
Date Created: 20210114 Latest Revision: 20210114
Update Code :
20210210
DOI :
10.1152/japplphysiol.00781.2020
PMID :
33444121
Czasopismo naukowe
Phrenic nerve damage may occur as a complication of specific surgical procedures, prolonged mechanical ventilation, or physical trauma. The consequent diaphragmatic paralysis or dysfunction can lead to major complications. To elucidate the role of the non-diaphragmatic respiratory muscles during partial or complete diaphragm paralysis induced by unilateral and bilateral phrenic nerve damage at different levels of ventilatory pressure support in an animal model. Ten pigs were instrumented, the phrenic nerve exposed from the neck and spontaneous respiration preserved at three levels of pressure support: high, low and null at baseline condition, after left phrenic nerve damage and bilateral phrenic nerve damage. Breathing pattern, thoraco-abdominal volumes and asynchrony and pressures were measured at each condition. Physiological breathing was predominantly diaphragmatic, homogeneously distributed between right and left sides. After unilateral damage, the paralyzed hemidiaphragm was passively dragged by the ipsilateral ribcage muscles and the contralateral hemidiaphragm. After bilateral damage, the drive to and the work of breathing of ribcage and abdominal muscles increased, to compensate for diaphragmatic paralysis, ensuing paradoxical thoraco-abdominal breathing. Increasing level of pressure support ventilation replaces this muscle group compensation. When the diaphragm is paralyzed (unilaterally and/or bilaterally), there is a coordinated reorganization of non-diaphragmatic respiratory muscles as compensation that might be obscured by high level of pressure support ventilation. Non-invasive thoraco-abdominal volume and asynchrony assessment could be useful in phrenic nerve injured patients to estimate the extent and type of inspiratory muscle dysfunction.

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