Journal of Applied Physiology, Vol 72, Issue 6 2311-2316, Copyright © 1992 by American Physiological Society

ARTICLES

Effects of pharyngeal lubrication on the opening of obstructed upper airway

H. Miki, W. Hida, Y. Kikuchi, T. Chonan, M. Satoh, N. Iwase and T. Takishima
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.

We examined the effect of electrical stimulation of the hypoglossal nerve and pharyngeal lubrication with artificial surfactant (Surfactant T-A) on the opening of obstructed upper airway in nine anesthetized supine dogs. The upper airway was isolated from the lower airway by transecting the cervical trachea. Upper airway obstruction was induced by applying constant negative pressures (5, 10, 20, and 30 cmH2O) on the rostral cut end of the trachea. Peripheral cut ends of the hypoglossal nerves were electrically stimulated by square-wave pulses at various frequencies from 10 to 30 Hz (0.2-ms duration, 5-7 V), and the critical stimulating frequency necessary for opening the obstructed upper airway was measured at each driving pressure before and after pharyngeal lubrication with artificial surfactant. The critical stimulation frequency for upper airway opening significantly increased as upper airway pressure became more negative and significantly decreased with lubrication of the upper airway. These findings suggest that greater muscle tone of the genioglossus is needed to open the occluded upper airway with larger negative intraluminal pressure and that lubrication of the pharyngeal mucosa with artificial surfactant facilitates reopening of the upper airway.

This article has been cited by other articles:

				A. R. Schwartz, H. Schneider, and P. L. Smith Upper airway surface tension: is it a significant cause of airflow obstruction during sleep? J Appl Physiol, November 1, 2003; 95(5): 1759 - 1760. [Full Text] [PDF]

				J. P. Kirkness, P. R. Eastwood, I. Szollosi, P. R. Platt, J. R. Wheatley, T. C. Amis, and D. R. Hillman Effect of surface tension of mucosal lining liquid on upper airway mechanics in anesthetized humans J Appl Physiol, July 1, 2003; 95(1): 357 - 363. [Abstract] [Full Text] [PDF]

				E F. Bailey and R. F Fregosi Pressure-volume behaviour of the rat upper airway: effects of tongue muscle activation J. Physiol., April 15, 2003; 548(2): 563 - 568. [Abstract] [Full Text] [PDF]

				J. P Kirkness, H. K Christenson, S. R Garlick, R. Parikh, K. Kairaitis, J. R Wheatley, and T. C Amis Decreased Surface Tension of Upper Airway Mucosal Lining Liquid Increases Upper Airway Patency in Anaesthetised Rabbits J. Physiol., March 1, 2003; 547(2): 603 - 611. [Abstract] [Full Text] [PDF]

				M.J. Morrell, Y. Arabi, B.R. Zahn, K.C. Meyer, J.B. Skatrud, and M. Safwan Badr Effect of surfactant on pharyngeal mechanics in sleeping humans: implications for sleep apnoea Eur. Respir. J., August 1, 2002; 20(2): 451 - 457. [Abstract] [Full Text] [PDF]

				R. Jokic, L. Bhagchandani, T. Zintel, M. Baetz, and M. F Fitzpatrick Effect of high versus low ambient humidity on the severity of obstructive sleep apnoea Thorax, August 1, 1999; 54(8): 711 - 713. [Abstract] [Full Text]

				R. JOKIC, A. KLIMASZEWSKI, J. MINK, and M. F. FITZPATRICK Surface Tension Forces in Sleep Apnea: The Role of a Soft Tissue Lubricant . A Randomized Double-blind, Placebo-controlled Trial Am. J. Respir. Crit. Care Med., May 1, 1997; 157(5): 1522 - 1525. [Abstract] [Full Text]

				T. Van Der Touw, A. B. H. Crawford, and J. R. Wheatley Effects of a synthetic lung surfactant on pharyngeal patency in awake human subjects J Appl Physiol, January 1, 1997; 82(1): 78 - 85. [Abstract] [Full Text] [PDF]