The compensatory responses to upper airway obstruction in normal subjects under propofol anesthesia

Hoshino, Yuko; Ayuse, Takao; Kurata, Shinji; Ayuse, Terumi; Schneider, Hartmut; Kirkness, Jason P.; Patil, Susheel P.; Schwartz, Alan R.; Oi, Kumiko

doi:10.1016/j.resp.2009.01.001

Cited by 43 publications

(36 citation statements)

References 41 publications

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“…In allergen sensitized and challenged mice Ti and PIF are primarily influenced by extrapleural obstructions and are typically elevated with Mch challenge when an obstruction exists. 25, 26 The Asthma and Dex-Asthma mice showed . Each value is the mean Ϯ SEM for n ϭ 8.…”

Section: Respiratory Parametersmentioning

confidence: 99%

Assessing Pulmonary Pathology by Detailed Examination of Respiratory Function

Vaickus

Bouchard

Kim

et al. 2010

The American Journal of Pathology

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Pulmonary inflammation causes multiple alterations within the lung , including mucus production , recruitment of inflammatory cells , and airway hyperreactivity (AHR). Measurement of AHR by direct , invasive means (eg , mechanical ventilation)or noninvasive techniques , like whole body plethysmography (WBP) , assesses the severity of pulmonary inflammation in animal models of inflammatory lung disease. Direct measurement of AHR is acknowledged as the most accurate method for assessing airway mechanics , but analysis of all data obtained from WBP may offer insights into which inflammatory aspects of the lung are altered along with AHR. Using WBP , we compared the respiratory parameters of two groups of mice sensitized with cockroach allergen. One group was treated with dexamethasone (Dex) before final challenge (DexAsthma) , while the other group received vehicle treatment (Asthma). Respiratory parameters from plethysmography revealed that Dex-Asthma mice compensated to maintain high minute ventilation , whereas Asthma mice showed significant impairment in minute ventilation despite increased peak expiratory flow (103 ؎ 5 ml/min vs. 69 ؎ 70 ml/ min). The WBP data suggest that enhanced air exchange in the Dex-Asthma mice results from significant decreases in airway mucus production. Additional studies with quantitative morphometry of histological sections confirmed that Dex reduced airway mucus. In conclusion , a detailed examination of WBP parameters can accurately assess the respiratory health of mice and will help direct additional studies. Numerous relevant animal models of disease have advanced the understanding of biology and provided important insights into the pathogenesis of human disease. The vast majority of these studies have been carried out in mice, due to their small size and the extensive characterization of the murine inflammatory system. Several robust murine models of allergic asthma have been developed in recent years, 1 including many experimental systems which induce allergic sensitization to ovalbumin (Ova). Although this system allows close control over the nature of the sensitizing agent, Ova is a relatively poor allergen and requires adjuvant co-administration or relatively high and frequent doses to achieve satisfactory immunization.2-5 Our model, conversely, uses an allergen composed of the defatted, total body extract of German cockroaches (cockroach allergen, CRA) containing appreciable lipopolysaccharide. CRA is a highly potent allergen (robust immunization is achieved with a dose thousands of times less than that required for Ova) and does not require an adjuvant for sensitization.6,7 Campbell et al 7 established the first CRA induced model of asthma in mice and demonstrated robust pulmonary inflammation with many asthma-like features. The complex nature of this allergen and its close correspondence with its urban environmental counterpart makes this model highly applicable to the study of human disease.In most models of allergic airways inflammation, disease severity and or therape...

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Section: Respiratory Parametersmentioning

confidence: 99%

Assessing Pulmonary Pathology by Detailed Examination of Respiratory Function

Vaickus

Bouchard

Kim

et al. 2010

The American Journal of Pathology

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“…Nonetheless, compared to isoflurane, where already 0.4 MAC, which is light sedation and comparable to a propofol plasma level of 1.0 μg/mL, caused significant upper airway collapse and complete depression of phasic genioglossus EMG activity (158), propofol seems to have a greater safety margin. As described earlier in this section Hoshino et al (279) showed that propofol increased upper airway collapsibility as measured by critical opening pressures to a similar degree as natural non-REM sleep.…”

Section: Effects On Upper Airway Musclesmentioning

confidence: 54%

Effects of Anesthetics, Sedatives, and Opioids on Ventilatory Control

Stuth

Stucke

Zuperku

2012

Comprehensive Physiology

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This article provides a comprehensive, up to date summary of the effects of volatile, gaseous, and intravenous anesthetics and opioid agonists on ventilatory control. Emphasis is placed on data from human studies. Further mechanistic insights are provided by in vivo and in vitro data from other mammalian species. The focus is on the effects of clinically relevant agonist concentrations and studies using pharmacological, that is, supraclinical agonist concentrations are de-emphasized or excluded.

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“…Two compensatory mechanisms can be induced in an attempt to maintain desired ventilation during partial airway obstruction with a consequent increase in inspiratory upper airway resistance: (1) Increase inspiratory muscle pressure or effort (i.e. increasing the work of breathing) (Badr et al, 1990;Younes and Riddle, 1981); and (2) increase the duty cycle of the inspiratory portion of the breath to maintain an equal tidal volume despite a reduced peak flow (Hoshino et al, 2009;Poon, 1989). The latter has been quantified by calculating the fractional inspiratory time (Jordan et al, 2007;Schneider et al, 2003); with the increase in the inspiratory period presumed to be associated with a reduced expiratory period (Onal and Lopata, 1986).…”

Section: Introductionmentioning

confidence: 99%

The relationship between partial upper-airway obstruction and inter-breath transition period during sleep

Mann

Edwards

Joosten

et al. 2017

Respiratory Physiology & Neurobiology

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I., The relationship between partial upper-airway obstruction and inter-breath transition period during sleep.Respiratory Physiology and Neurobiology http://dx.doi.org/10. 1016/j.resp.2017.06.006 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Highlights• Short pauses (transition periods) between breaths are often observed during sleep.• We hypothesized that the transition period reduces as inspiratory period increases.• Unobstructed breathing and events with partial airway obstruction were identified.• We observed an increase in the inspiratory period during upper airway obstruction.• A reduction in the transition period rather than the expiratory period was observed.3 AbstractShort pauses or "transition-periods" at the end of expiration and prior to subsequent inspiration are commonly observed during sleep in humans. However, the role of transition periods in regulating ventilation during physiological challenges such as partial airway obstruction (PAO) has not been investigated. Twenty-nine obstructive sleep apnea patients and eight controls underwent overnight polysomnography with an epiglottic catheter. Sustained-PAO segments (increased epiglottic pressure over ≥5 breaths without increased peak inspiratory flow) and unobstructed reference segments were manually scored during apnea-free non-REM sleep. Nasal pressure data was computationally segmented into inspiratory (TI, shortest period achieving 95% inspiratory volume), expiratory (TE, shortest period achieving 95% expiratory volume), and inter-breath transition period (TTrans, period between TE and subsequent TI). Compared with reference segments, sustained-PAO segments had a mean relative reduction in TTrans (−24.7±17.6%, P<0.001), elevated TI (11.8±10.5%, P<0.001), and a small reduction in TE (−3.9±8.0, P≤0.05). Compensatory increases in inspiratory period during PAO are primarily explained by reduced transition period and not by reduced expiratory period.

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The compensatory responses to upper airway obstruction in normal subjects under propofol anesthesia

Cited by 43 publications

References 41 publications

Assessing Pulmonary Pathology by Detailed Examination of Respiratory Function

Assessing Pulmonary Pathology by Detailed Examination of Respiratory Function

Effects of Anesthetics, Sedatives, and Opioids on Ventilatory Control

The relationship between partial upper-airway obstruction and inter-breath transition period during sleep

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