scholarly journals The haemodynamic response to incremental increases in negative intrathoracic pressure in healthy humans

2018 ◽  
Vol 103 (4) ◽  
pp. 581-589 ◽  
Author(s):  
William S. Cheyne ◽  
Jinelle C. Gelinas ◽  
Neil D. Eves
Keyword(s):  
Intrathoracic Pressure ◽  
Haemodynamic Response ◽  
Healthy Humans ◽  
Negative Intrathoracic Pressure

Neurocirculatory consequences of abrupt change in sleep state in humans

1996 ◽  
Vol 80 (5) ◽  
pp. 1627-1636 ◽  
Author(s):  
B. J. Morgan ◽  
D. C. Crabtree ◽  
D. S. Puleo ◽  
M. S. Badr ◽  
F. Toiber ◽  
...  
Keyword(s):  
Heart Rate ◽  
Arterial Pressure ◽  
Pressor Response ◽  
Muscle Sympathetic Nerve Activity ◽  
Intrathoracic Pressure ◽  
Nrem Sleep ◽  
Auditory Stimuli ◽  
Sleep State ◽  
Healthy Humans ◽  
Pressor Responses

The arterial pressure elevations that accompany sleep apneas may be caused by chemoreflex stimulation, negative intrathoracic pressure, and/or arousal. To assess the neurocirculatory effects of arousal alone, we applied graded auditory stimuli during non-rapid-eye-movement (NREM) sleep in eight healthy humans. We measured muscle sympathetic nerve activity (intraneural microelectrodes), electroencephalogram (EEG; C4/A1 and O1/A2), arterial pressure (photoelectric plethysmography), heart rate (electrocardiogram), and stroke volume (impedance cardiography). Auditory stimuli caused abrupt increases in systolic and diastolic pressures (21 +/- 2 and 15 +/- 1 mmHg) and heart rate (11 +/- 2 beats/min). Cardiac output decreased (-10%). Stimuli that produced EEG evidence of arousal evoked one to two large bursts of sympathetic activity (316 +/- 46% of baseline amplitude). Stimuli that did not alter EEG frequency produced smaller but consistent pressor responses even though no sympathetic activation was observed. We conclude that arousal from NREM sleep evokes a pressor response caused by increased peripheral vascular resistance. Increased sympathetic outflow to skeletal muscle may contribute to, but is not required for, this vasoconstriction. The neurocirculatory effects of arousal may augment those caused by asphyxia during episodes of sleep-disordered breathing.

scholarly journals Therapeutic Strategies for Sleep Apnea in Hypertension and Heart Failure

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Akiko Noda ◽  
Seiko Miyata ◽  
Yoshinari Yasuda
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Sleep Apnea ◽  
Cardiac Function ◽  
Blood Pressure Reduction ◽  
Intrathoracic Pressure ◽  
Left Ventricular ◽  
Cpap Treatment ◽  
Negative Intrathoracic Pressure ◽  
Obstructive Sleep

Sleep-disordered breathing (SDB) causes hypoxemia, negative intrathoracic pressure, and frequent arousal, contributing to increased cardiovascular disease mortality and morbidity. Obstructive sleep apnea syndrome (OSAS) is linked to hypertension, ischemic heart disease, and cardiac arrhythmias. Successful continuous positive airway pressure (CPAP) treatment has a beneficial effect on hypertension and improves the survival rate of patients with cardiovascular disease. Thus, long-term compliance with CPAP treatment may result in substantial blood pressure reduction in patients with resistant hypertension suffering from OSAS. Central sleep apnea and Cheyne-Stokes respiration occur in 30–50% of patients with heart failure (HF). Intermittent hypoxemia, nocturnal surges in sympathetic activity, and increased left ventricular preload and afterload due to negative intrathoracic pressure all lead to impaired cardiac function and poor life prognosis. SDB-related HF has been considered the potential therapeutic target. CPAP, nocturnal O2therapy, and adaptive servoventilation minimize the effects of sleep apnea, thereby improving cardiac function, prognosis, and quality of life. Early diagnosis and treatment of SDB will yield better therapeutic outcomes for hypertension and HF.

Effect of lung volume on the respiratory action of the canine pectoral muscles

1992 ◽  
Vol 73 (6) ◽  
pp. 2408-2412 ◽  
Author(s):  
S. R. Muza ◽  
G. J. Criner ◽  
S. G. Kelsen
Keyword(s):  
Electrical Stimulation ◽  
Lung Volume ◽  
Intrathoracic Pressure ◽  
Pectoral Muscle ◽  
Positive Pressure ◽  
Rib Cage ◽  
Mechanical Coupling ◽  
Negative Intrathoracic Pressure ◽  
Pressure Changes ◽  
Stimulation Of

Lung volume influences the mechanical action of the primary inspiratory and expiratory muscles by affecting their precontraction length, alignment with the rib cage, and mechanical coupling to agonistic and antagonistic muscles. We have previously shown that the canine pectoral muscles exert an expiratory action on the rib cage when the forelimbs are at the torso's side and an inspiratory action when the forelimbs are held elevated. To determine the effect of lung volume on intrathoracic pressure changes produced by the canine pectoral muscles, we performed isolated bilateral supramaximal electrical stimulation of the deep pectoral and superficial pectoralis (descending and transverse heads) muscles in 15 adult supine anesthetized dogs during hyperventilation-induced apnea. Lung volume was altered by application of a negative or positive pressure (+/- 30 cmH2O) to the airway. In all animals, selective electrical stimulation of the descending, transverse, and deep pectoral muscles with the forelimbs held elevated produced negative intrathoracic pressure changes (i.e., an inspiratory action). Moreover, with the forelimbs elevated, increasing lung volume decreased both pectoral muscle fiber precontraction length and the negative intrathoracic pressure changes generated by contraction of each of these muscles. Conversely, with the forelimbs along the torso, increasing lung volume lengthened pectoral muscle precontraction length and augmented the positive intrathoracic pressure changes produced by muscle contraction (i.e., an expiratory action). These results indicate that lung volume significantly affects the length of the canine pectoral muscles and their mechanical actions on the rib cage.

Bilateral pneumothorax after emergency tracheotomy: two case reports and a review of the literature

1994 ◽  
Vol 108 (1) ◽  
pp. 69-70 ◽  
Author(s):  
F. Ameye ◽  
W. Mattelin ◽  
K. Ingels ◽  
R. Bradwell
Keyword(s):  
Airway Obstruction ◽  
Case Reports ◽  
Upper Airway ◽  
Intrathoracic Pressure ◽  
Upper Airway Obstruction ◽  
Review Of The Literature ◽  
Bilateral Pneumothorax ◽  
Negative Intrathoracic Pressure ◽  
Emergency Tracheotomy

AbstractBilateral pneumothorax may occur after emergency tracheotomy, if a significant upper airway obstruction with a large negative intrathoracic pressure exists.

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