Respiratory physiology & neurobiology
-
Respir Physiol Neurobiol · Jan 2005
Comparative Study Clinical TrialHow does lobeline injected intravenously produce a cough?
In order to examine, whether the lobeline-induced cough is a true reflex or a voluntary effort to get rid of its irritating sensations in the upper respiratory tract, we systematically studied the cough response to lobeline, of subjects who were unable to make conscious discriminations i.e. were either comatose (n=4) or anaesthetized (n=5). 8 microg/kg lobeline injected into the right atrium of one and 29 microg/kg intravenously (i.v.) into another evenly and spontaneously breathing comatose subject produced a cough after 4s and 12s, respectively. Cough was repeatable and showed a dose response relationship i.e., its latency decreasing and its duration/intensity increasing with the dose. In a third subject, capable only of weak spontaneous respiration, a relatively high dose injected into the right atrium (44 microg/kg) generated a pronounced cough-like respiratory movement superimposed on the artificial ventilation and also during the apnoea after disconnecting the pump. ⋯ It may be noted that neither the later dose nor the latency or duration of cough that it produced were significantly different from the pre anaesthesia values (P>0.05). These two sets of results show unequivocally that the lobeline-induced cough is evoked reflexly; its magnitude in the conscious state could vary by subjective influences. We discuss the likelihood of its origin from juxtapulmonary capillary receptors.
-
Respir Physiol Neurobiol · Jan 2005
Comparative StudyOn the interaction between respiratory compartments during passive expiration in ARDS patients.
Relaxed expiratory volume-time profile has been frequently analysed by fitting exponential functions of time to one- or two-compartment models. In the latter case, the two exponential constants are assumed as representing the time constants of both compartments. Least-square fittings on the experimental data of five consecutive mechanically ventilated supine patients with acute respiratory distress syndrome (ARDS) were performed using rate-constants (flow/volume ratio) as parameters in order to obtain the model matching. ⋯ Model matching was optimal with significant, reliable parameter values. As a result, the use of a PEEP in ARDS patients: (a) delayed expiration; (b) decreased the percentage initial volume contribution of the slow-emptying compartment; and, (c) modified the interaction between compartments. The volume-time profile of the second compartment was found to increase at the beginning of expiration, and, then, progressively decayed towards zero, showing a maximum, although the overall curve decreased throughout expiration.