Respiratory Physiology & Neurobiology最新文献_第7页

Oscillation mechanics in adults with cystic fibrosis: Effect of airway obstruction and detection of early dysfunction 囊性纤维化成人的振荡力学：气道阻塞的影响和早期功能障碍的检测

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-12-11 DOI: 10.1016/j.resp.2025.104526

Caroline O. Ribeiro , Cíntia M.S. Sousa , Manuela G. Torres , Raphael F.J. Oliveira , Agnaldo J. Lopes , Pedro L. Melo

Respiratory oscillometry can help understand pathophysiological changes and detect early abnormalities. However, little is known about oscillometry in adult individuals with cystic fibrosis (CF). This research examines the emerging role of respiratory oscillometry in the context of groups of adult CF patients associated with greater severity. The contributions to our understanding of the respiratory abnormalities along the course of increasing severity and the diagnostic use of this method were also evaluated.

This cross-sectional study was conducted in 15 individuals with no history of smoking or pulmonary diseases (control group), and 52 individuals with diagnoses of CF were studied, being classified into 10 normal to the spirometric exam, 14 mild, 16 moderate, and 12 severe cases. The mean age of the patients was 25.2 years.

Airway obstruction resulted in increased values of resistance at 4 Hz (R4, Kruskal-Wallis, p = 0.0002), 12 Hz (R12, p = 0.0032), and resistance dependence (R4-R20, p < 0.0001). Similar analysis revealed reductions in dynamic compliance (Cdyn, p < 0.0001) and ventilation homogeneity, as assessed by resonance frequency (fr, p < 0.0001) and reactance area (Ax, p < 0.0001). Respiratory work, as measured by the impedance modulus, also showed increased values (Z4, p < 0.0001). Oscillometric indexes showed moderate to good correlations with spirometric and plethysmographic parameters. The early abnormalities in mild airway obstruction were detected by fr and Ax with adequate accuracy (AUC>0.70). At the same time, R4-R20, fr, and Ax achieved high diagnostic accuracy (AUC>0.95) in diagnosing late-stage respiratory changes. We conclude that 1) airflow obstruction in adults with CF introduces significant changes in the resistive and reactive properties of the respiratory system compared with healthy subjects; 2) these changes are proportional to airway obstruction; and 3) oscillometry provides novel information suitable to facilitate the diagnosis of respiratory abnormalities in adults with CF.

呼吸振荡测量可以帮助了解病理生理变化和发现早期异常。然而，对囊性纤维化（CF）成人个体的振荡测量知之甚少。本研究探讨了呼吸振荡测量法在与严重程度相关的成年CF患者组中的新作用。对我们对呼吸异常随着严重程度的增加而增加的认识以及该方法的诊断应用的贡献也进行了评估。本横断面研究选取了15例无吸烟史或肺部疾病的个体（对照组），52例诊断为CF的个体进行研究，肺活量检查分为正常至正常10例，轻度14例，中度16例，重度12例。患者平均年龄25.2岁。气道阻塞导致4 Hz （R4, Kruskal-Wallis, p = 0.0002）、12 Hz （R12, p = 0.0032）和阻力依赖性（R4- r20, p <； 0.0001）的阻力值升高。类似的分析显示，通过共振频率（fr, p <； 0.0001）和电抗面积（Ax, p <； 0.0001）评估，动态顺应性（Cdyn, p <； 0.0001）和通风均匀性降低。通过阻抗模量测量的呼吸功也显示出增加的值（Z4, p <； 0.0001）。振荡指标与肺活量测定和容积描记参数表现出中度至良好的相关性。fr和Ax检测轻度气道阻塞的早期异常具有足够的准确性（AUC>0.70）。同时，R4-R20、fr、Ax在诊断晚期呼吸变化方面具有较高的诊断准确率（AUC>0.95）。我们得出结论：1)与健康受试者相比，CF成人气流阻塞导致呼吸系统的阻力和反应特性发生显著变化；2)这些变化与气道阻塞成正比；3)振荡测量法提供了适合于诊断成人CF呼吸异常的新信息。

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引用次数: 0

Sex differences in the cardiovascular and ventilatory responses to arm or leg mechanoreflex activation 对手臂或腿部机械反射激活的心血管和通气反应的性别差异。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-12-10 DOI: 10.1016/j.resp.2025.104527

T.J. Pereira , H. Edgell

The mechanoreflex mediates the initial cardiorespiratory response during dynamic exercise, via input from the mechanical deformation of the exercising muscle. In response to passive movement (PM), engaging a greater number of limbs elicits a higher heart rate response. Additionally, males have larger pressor responses to arm PM; however, no sex differences exist in the pressor response to leg PM. Considering that the legs are a larger muscle mass and the pressor response to leg PM was not different between sexes, this may suggest inherent limb-dependant differences. This study aimed to determine sex differences and the role of limb volume and muscle strength on the cardiorespiratory responses to arm and leg PM. Females were smaller (i.e., stature, limb volume), less fit and had weaker handgrip strength compared to males (all p < 0.05); although, both sexes had similar plantarflexion strength (p = 0.3). During arm PM, only males experienced an increased MAP response to arm PM (p < 0.001), compared to females (p < 0.05); however, this sex difference was eliminated when accounting for disparities in forearm volume. Males and females had similar cardiorespiratory responses to leg PM (all p > 0.05). Further, greater plantarflexion strength enhanced the ventilatory response to leg PM in both sexes (p = 0.024). Based on covariate analysis, differences in limb volume and muscle strength contributed almost half of the variability in the cardiorespiratory responses to arm or leg PM. Contrary to our hypotheses, the results of the current study suggest that the previously observed sex and limb-dependant differences were influenced by disparities in limb characteristics (i.e., volume or strength).

机械反射通过运动肌肉的机械变形输入，介导动态运动时的初始心肺反应。在被动运动（PM）的反应中，参与更多的肢体会引起更高的心率反应。此外，男性对手臂PM有更大的升压反应；然而，腿部PM的升压反应不存在性别差异。考虑到腿部的肌肉量更大，腿部PM的加压反应在性别之间没有差异，这可能表明存在固有的肢体依赖性差异。本研究旨在确定性别差异以及肢体体积和肌肉力量对手臂和腿部PM心肺反应的作用。与男性相比，女性更小（即身高、肢体体积）、更不适合、握力更弱（均p0.05）。此外，更大的跖屈强度增强了两性对腿部PM的通气反应（p=0.024）。基于协变量分析，肢体体积和肌肉力量的差异贡献了手臂或腿部PM心肺反应变异性的近一半。与我们的假设相反，目前的研究结果表明，先前观察到的性别和肢体依赖差异受到肢体特征差异（即体积或力量）的影响。

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引用次数: 0

Key hemodynamic parameters during induced hypothermia cooling phase in healthy and injured piglets 健康仔猪和受伤仔猪诱导低温冷却阶段的关键血流动力学参数。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-12-08 DOI: 10.1016/j.resp.2025.104525

Lucía Vaamonde , Miguel Martell , Patricia Vollono , Tatiana Gagliardi , Cecilia Fernández , Fernando E. Silvera , M. Fernanda Blasina

Hypoxic-ischemic encephalopathy (HIE) in newborns treated with therapeutic hypothermia(TH) represents a challenge, especially during cooling phase which could be less controlled. This study explored the hemodynamic effects of the cooling phase of TH in a piglet model of perinatal asphyxia with lung injury. Cardiovascular parameters, including systemic arterial pressure (SAP), pulmonary artery pressure (PAP), heart rate (HR), and cardiac output (CO) were monitored from 38.5 to 39.5°C -physiological- to 31.0°C. The piglets were divided into TH without (H, n = 12) and TH with lung injury (Hi, n = 7). Both groups showed decreases in SAP, HR, and CO, more pronounced in Hi. PAP was consistently higher in Hi, though it decreased significantly below 33.5°C (40 % less at 31°C, compared to baseline). Myocardial contractility decreased along the cooling, particularly in Hi group, explaining CO reduction (40 % and 35 % in Hi and H group, respectively). No significant changes were observed in brain monitoring, oxygen extraction ratio, or acid-base status. We concluded that in HIE model, close hemodynamic monitoring during the induction phase of TH as well as monitoring of tissue oxygenation warrants detection of changes, a special challenge when lung injury is developed. Although hemodynamic changes were observed with TH in this model, it was not contraindicated since brain oxygenation was unchanged. These data suggest that TH may be a viable option for human neonates with similar conditions, but further research is essential to evaluate its safety and efficacy in this vulnerable population.

治疗性低温（TH）治疗新生儿缺氧缺血性脑病（HIE）是一个挑战，特别是在冷却阶段，可以较少控制。本研究探讨了TH冷却期对围产期窒息肺损伤仔猪模型的血流动力学影响。心血管参数，包括全身动脉压（SAP）、肺动脉压（PAP）、心率（HR）和心输出量（CO）在38.5-39.5°C（生理）至31.0°C监测。将仔猪分为未肺损伤组（H, n=12）和肺损伤组（Hi, n=7）。两组均表现出SAP、HR和CO的下降，其中Hi的下降更为明显。Hi患者的PAP始终较高，但在33.5°C以下显著下降（与基线相比，在31°C时降低40%）。心肌收缩力随着冷却而下降，特别是在Hi组，这解释了CO的减少（Hi组和H组分别为40%和35%）。脑监测、氧气提取比或酸碱状态未见明显变化。我们得出结论，在HIE模型中，在TH诱导阶段密切监测血流动力学以及监测组织氧合可以检测到变化，这是肺损伤发生时的特殊挑战。虽然在该模型中观察到TH的血流动力学改变，但由于脑氧合不变，它不是禁忌。这些数据表明，对于有类似情况的人类新生儿，TH可能是一种可行的选择，但需要进一步的研究来评估其在这一脆弱人群中的安全性和有效性。

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引用次数: 0

Diethelm Richter (1943-2025); a life in Respiratory Neurobiology. Diethelm Richter (1943-2025)；呼吸神经生物学的生活。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-25 DOI: 10.1016/j.resp.2025.104524

K Michael Spyer, Julian F R Paton

引用次数: 0

Diethelm Richter (1943–2025): A life in respiratory neurobiology Diethelm Richter(1943-2025)：呼吸神经生物学的一生。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-25 DOI: 10.1016/j.resp.2025.104524

K. Michael Spyer, Julian F.R. Paton

引用次数: 0

Description of automatic-voluntary dissociation of breathing in multiple sclerosis 多发性硬化症患者呼吸自动-自主分离的描述。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-20 DOI: 10.1016/j.resp.2025.104523

Alicia Garcia Alvarez , Djamel Bensmail , Caroline Hélie , Manon Tamiatto , Isabelle Bossard , Jonathan Levy , Hélène Prigent

Background

Respiratory dysfunction in people with multiple sclerosis (PwMS) is often attributed to respiratory pump failure, yet central respiratory drive and automatic breathing control remain underexplored. We assessed the prevalence of breathing automatic-voluntary dissociation (AVD) in PwMS.

Methods

We analyzed prospectively collected data from a tertiary care rehabilitation center observational cohort. All adult PwMS, who underwent pulmonary function testing, including a CO₂ ventilatory response test, while relapse-free for ≥ 3 months, between January 2018 and December 2024 were screened. AVD was defined by maximal tidal volume (VTmax) during CO₂ response test higher than vital capacity (VC)(VTmax/VC>1), reflecting discordance between voluntary and automatic respiratory response. Univariate analysis and multivariate logistic regression were performed to identify variables associated with AVD.

Results

Fifty-five PwMS were included (age 59 ±7 years, disease duration 23 ± 11 years, women 64 %, median EDSS 8[7,5;8,5]). Restrictive ventilatory pattern was observed in 65 %, 32 % being severely impaired, and with cough impairment in 64 %. Eighteen (33 %) presented AVD. It was associated with significantly lower VC, inspiratory capacity, peak cough flow (p < 0.001), higher EDSS scores and greater use of respiratory support devices (CPAP/NIV, p = 0.002; mechanical in-exsufflation, p = 0.002).

Conclusion

Breathing AVD is frequent in PwMs with severe disease, underscoring the relevance of thorough respiratory assessment to individualize respiratory care.

背景：多发性硬化症（PwMS）患者的呼吸功能障碍通常归因于呼吸泵衰竭，但对中枢呼吸驱动和自动呼吸控制的研究尚不充分。我们评估了呼吸自动-自愿分离（AVD）在PwMS中的患病率。方法：我们对来自三级康复中心观察队列的前瞻性数据进行分析。筛查2018年1月至2024年12月期间接受肺功能测试（包括CO₂通气反应测试）且无复发≥3个月的所有成年PwMS。AVD的定义为CO₂反应试验时最大潮气量（VTmax）高于肺活量（VTmax/VC>1），反映自主呼吸反应与自动呼吸反应之间的不一致。采用单因素分析和多因素logistic回归来确定与AVD相关的变量。结果：纳入55例PwMS患者（年龄59岁 ±7岁，病程23±11年，女性64%，中位EDSS 8[7,5;8,5]）。65%的患者存在限制性通气模式，32%的患者存在严重通气障碍，64%的患者存在咳嗽障碍。18例（33%）出现AVD。结论：呼吸性AVD在病情严重的PwMs患者中较为常见，需要进行全面的呼吸评估以进行个性化的呼吸护理。

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引用次数: 0

AAV9 gene therapy to target respiratory insufficiency in the D2.mdx mouse model of duchenne muscular dystrophy AAV9基因治疗D2患者呼吸功能不全。mdx小鼠杜氏肌营养不良模型。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-14 DOI: 10.1016/j.resp.2025.104513

Debolina D. Biswas , Nicolas H. Han , Marán Y. Hernández Rodríguez, Jane Lee, Sarra M. Abdelbarr, Evelyn R. Scarrow, Mai K. ElMallah

Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder caused by a deficiency of dystrophin. Dystrophin deficiency leads to progressive muscle weakness, including involvement of the respiratory muscles, ultimately resulting in respiratory failure. Adeno-associated virus (AAV)-mediated gene therapy carrying a microdystrophin (µDys) transgene was recently approved by the Food and Drug Administration (FDA); however, its effects on the respiratory system remain unclear. Further, effective transduction of all muscle groups requires high systemic AAV doses, which are associated with dose-dependent toxicities. In this study, we investigated whether respiratory-directed gene therapy can 1) specifically target respiratory muscles and (2) reduce the total AAV-µDys dose required for therapeutic benefit. We compared the efficiency of AAV9-µDys delivery using different administration routes and dosages in D2.mdx mice, a mouse model of DMD. AAV9-µDys was administered either systemically at a high dose, locally at intermediate doses via intralingual and intrathoracic injections, or through a combination of systemic and respiratory-directed intermediate dosing. All treatments resulted in improved respiratory muscle dystrophin expression and decreased pathology; however, the intermediate and combination dosing led to lower liver vector genome expression. In conclusion, respiratory-targeted gene therapy can improve respiratory muscle pathology while reducing the need for high systemic AAV doses associated with liver toxicity.

杜氏肌营养不良症（DMD）是一种由肌营养不良蛋白缺乏引起的x连锁隐性疾病。肌营养不良蛋白缺乏会导致进行性肌肉无力，包括累及呼吸肌，最终导致呼吸衰竭。携带微营养不良蛋白（µDys）转基因的腺相关病毒（AAV）介导的基因治疗最近获得了美国食品和药物管理局（FDA）的批准；然而，它对呼吸系统的影响尚不清楚。此外，所有肌群的有效转导需要高的全身AAV剂量，这与剂量依赖性毒性有关。在这项研究中，我们研究了呼吸导向基因治疗是否可以1)特异性靶向呼吸肌，(2)减少治疗获益所需的总AAV-µDys剂量。我们比较了不同给药途径和给药剂量下AAV9-µDys在D2中的递送效率。mdx小鼠，DMD小鼠模型。AAV9-µDys采用高剂量全身性给药、舌内和胸内局部中剂量给药或全身和呼吸定向中剂量联合给药。所有治疗均改善了呼吸肌肌营养不良蛋白的表达，降低了病理水平；然而，中间剂量和联合剂量导致肝脏载体基因组表达降低。总之，呼吸靶向基因治疗可以改善呼吸肌病理，同时减少与肝毒性相关的高系统性AAV剂量的需要。

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引用次数: 0

Development of periodic breathing in awake healthy individuals under controlled progressive hypoxia 控制进行性缺氧下健康个体周期性呼吸的发展

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-14 DOI: 10.1016/j.resp.2025.104512

D. van Scheppingen , M. de Haan , M. Gerrits , STJ van der Landen , GM Lötgerink , R. De Jongh , R. Bezemer

The aim of this study was to better understand the ventilatory response to controlled progressive hypoxia in healthy individuals and identify factors influencing the development of periodic breathing under hypoxic conditions. The study was conducted in a hypoxia room at the Complementary Medical Centre in Genk, Belgium. Eighteen healthy participants were subjected to controlled progressive hypoxia, with oxygen levels ranging from 0.21 to 0.10. Oxygen saturation (SpO₂) was measured using a Nellcor® PM10N pulse oximeter, and carbon dioxide levels, including end-tidal carbon dioxide (EtCO₂), were monitored using a Philips LoFlo® sidestream device. Recorded data of SpO₂ sensor and capnography were analyzed whether sex, age, and Body Mass Index (BMI) were factors influencing the participants’ ventilatory response to hypoxic conditions.

Results

showed that 22 % of the study participants developed periodic breathing, all of whom were men, particularly older individuals, with an average age of 40.0 ± 16.2 years (p = 0.026). There was a notable sex-specific response, with 100 % of periodic breathing cases being male (p = 0.078). Significant correlations were found within the periodic breathing group: BMI correlated with the SpO₂ value at the start of PB (R²=0.987, p = 0.013), the pulse rate at the start of periodic breathing (R²=-0.992, p = 0.008), and the EtCO₂ at the end of the first breath after the apneic phase (R²=0.908, p = 0.092). These findings indicate that sex, age, and BMI are critical factors in determining an individual's ventilatory response to hypoxic conditions. Periodic breathing developed exclusively in men, and the physiological state at the onset of periodic breathing, measured by the SpO₂ and pulse rate, was significantly correlated with BMI.

本研究的目的是为了更好地了解健康个体对控制性进行性缺氧的通气反应，并确定影响缺氧条件下周期性呼吸发展的因素。这项研究是在比利时根克补充医疗中心的一个缺氧室进行的。18名健康的参与者接受了控制进行性缺氧，氧气水平从0.21到0.10不等。使用Nellcor®PM10N脉搏血氧仪测量氧饱和度（SpO2），使用Philips LoFlo®侧流装置监测二氧化碳水平，包括潮末二氧化碳（EtCO2）。分析SpO2传感器和血管造影记录的数据，性别、年龄和身体质量指数（BMI）是否是影响参与者缺氧条件下通气反应的因素。结果：22%的研究参与者出现周期性呼吸，全部为男性，特别是老年人，平均年龄为40.0±16.2岁（p=0.026）。有显著的性别特异性反应，100%的周期性呼吸病例为男性（p=0.078）。在周期性呼吸组中，BMI与PB开始时的SpO2值（R2=0.987, p=0.013）、周期性呼吸开始时的脉搏率（R2=-0.992, p=0.008）、窒息期后第一次呼吸结束时的EtCO2 （R2=0.908, p=0.092）相关。这些发现表明，性别、年龄和BMI是决定个体对缺氧条件通气反应的关键因素。周期性呼吸只发生在男性身上，周期性呼吸开始时的生理状态（通过SpO2和脉搏率测量）与BMI显著相关。

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引用次数: 0

Autonomic cardiac regulation to slow-paced respiration in seated and supine positions 自主心脏调节慢节奏呼吸在坐位和仰卧位。

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-11-07 DOI: 10.1016/j.resp.2025.104511

Florian Chouchou , Claire Fournié , Georges Dalleau , Chantal Verkindt

Purpose

Respiratory modulation and positional control are the main two regulators of cardiac autonomic activity. Although both slow-paced breathing and supine position promote parasympathetic regulation, their interaction remains poorly documented. Here, the objective of this work is to study the interaction between these two autonomic controls.

Methods

Twenty healthy volunteers (12 males, 8 females), age of 25.9 ± 3.9 years were included in this study. They were randomly subjected to 6 different slow and controlled breathing at 4.5, 5, 5.5, 6, 6.5, and 7 min/cycles for 3 min in supine or seated position after a 3 min baseline recording in spontaneous breathing. ECG was continuously monitored and RR intervals (RRI), total power (Ptot), the standard deviation of normal R–R intervals (SDNN), high frequency power (HF), the root mean square of successive R–R interval differences (RMSSD), and low frequency power (LF) were calculated to study autonomic regulation.

Results

We observed (1) a similar increase in parasympathetic (RMSSD and LF) and overall autonomic (RRI, Ptot, and SDNN) activities in slow-paced breathing conditions, whatever the respiratory rate in comparison with control spontaneous breathing; (2) these autonomic parameters increased in sitting position, but in parasympathetic (RMSSD and LF) and overall autonomic (Ptot, and SDNN) activities interacted with respiratory control and were higher in seated slow-paced breathing.

Conclusion

These results showed that (1) whatever the slow-paced breathing frequency, slow breathing favours parasympathetic control and slow heart rhythm; and (2) seated position favors autonomic cardiovascular interaction between respiratory modulation and positional control.

目的：呼吸调节和体位控制是心脏自主活动的两种主要调节机制。虽然慢节奏呼吸和仰卧位都能促进副交感神经调节，但它们之间的相互作用文献很少。在这里，这项工作的目的是研究这两个自主控制之间的相互作用。方法：选取健康志愿者20例，男12例，女8例，年龄25.9±3.9岁。在自主呼吸基线记录3分钟后，他们随机接受6种不同的缓慢和控制呼吸，分别为4.5、5、5.5、6、6.5和7min/次，仰卧或坐位，持续3分钟。连续监测心电图，计算RR间期（RRI）、总功率（ppt）、正常R-R间期标准差（SDNN）、高频功率（HF）、连续R-R间期差的均方根（RMSSD）、低频功率（LF），研究自主调节。结果：我们观察到(1)在慢节奏呼吸条件下，无论呼吸频率如何，与对照自主呼吸相比，副交感神经（RMSSD和LF）和整体自主神经（RRI， pto和SDNN）活动也有类似的增加；(2)这些自主神经参数在坐姿时增加，但副交感神经（RMSSD和LF）和整体自主神经（ppt和SDNN）活动与呼吸控制相互作用，并且在坐姿慢节奏呼吸时更高。结论：结果表明：(1)无论呼吸频率多慢，呼吸慢有利于副交感神经控制和心律减慢；(2)坐姿有利于自主心血管呼吸调节和位置控制之间的相互作用。

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引用次数: 0

Modality of tracheal sensory inputs modulate swallowing reflexibility and discharge patterns of neurons of the dorsal swallowing group in rats 气管感觉输入方式调节大鼠背侧吞咽组神经元的吞咽反射和放电模式

IF 1.6 4区医学 Q3 PHYSIOLOGY

Respiratory Physiology & Neurobiology

Pub Date : 2025-10-30 DOI: 10.1016/j.resp.2025.104510

Eriko Shimazaki , Tomoya Ishida , Yuki Sato , Hiroyuki Shuto , Akimichi Minesaki , Rishi R. Dhingra , Mathias Dutschmann , Yoichiro Sugiyama

Objective

Desensitization of the larynx significantly impairs swallowing function in patients with tracheostomies. Although it is clinically relevant that adequate airway clearance helps to improve swallowing responsiveness, a robust theoretical proposal has not been provided. Hence, we investigated the impact of prolonged fluid irritation of the trachea and larynx on the swallowing reflex. We additionally analyzed discharge activities of the swallowing-related neurons in presence and absence of airway fluid accumulation.

Methods

We analyzed the likelihood of swallowing evoked by electrical stimulation of the superior laryngeal nerve or oral water injection before and after removal of fluid accumulation in the trachea and larynx using air flow in perfused rats (n = 15). We then transected the superior laryngeal and vagus nerves which convey critical laryngotracheal sensory information. We recorded changes in the neuronal activities in the presence or absence of airway fluid contamination using multi-electrode arrays (n = 8).

Results

The frequency of swallows was increased by the removal of airway fluid accumulation and this change lasted at least 60 min. The effects were abolished following the section of either the superior laryngeal or vagus nerve. Specifically, we found that centrally recorded swallowing neurons showed changes in spontaneous discharge activities in the presence or absence of fluid-related laryngotracheal sensory stimulation.

Conclusion

A diminished likelihood of swallowing caused by prolonged airway irritation can be cautiously improved through airway clearance with respiratory airflow via central and peripheral neuromodulation. Our findings provide a fundamental mechanism to recover impaired laryngotracheal susceptibility for severe dysphagia such as post-tracheostomy dysphagia.

目的探讨气管切开术患者咽喉脱敏对吞咽功能的影响。虽然充分的气道间隙有助于改善吞咽反应性在临床上是相关的，但还没有一个强有力的理论建议。因此，我们研究了气管和喉部长期液体刺激对吞咽反射的影响。我们还分析了存在和不存在气道积液时吞咽相关神经元的放电活动。方法分析灌注大鼠气管及喉部积液清除前后电刺激喉上神经或口服水引起吞咽的可能性（n = 15）。然后我们横切喉上神经和迷走神经，它们传递关键的喉-气管感觉信息。我们使用多电极阵列记录了存在或不存在气道液体污染时神经元活动的变化（n = 8）。结果随着气道积液的清除，吞咽次数增加，这种变化持续至少60 min。在切除喉上神经或迷走神经后，这种效果消失。具体来说，我们发现中央记录的吞咽神经元在存在或不存在与液体相关的喉气管感觉刺激时表现出自发放电活动的变化。结论通过调节中枢神经和周围神经的呼吸气流清除气道，可减少气道刺激引起的吞咽可能性。我们的研究结果为恢复严重吞咽困难（如气管切开术后吞咽困难）的受损喉气管易感性提供了一种基本机制。

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引用次数: 0