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Department of Respiratory Medicine, Westmead Hospital, Westmead, New South Wales 2145, Australia
Received 27 February 1996; accepted in final form 13 August 1996.
Van der Touw, T., A. B. H. Crawford, and J. R. Wheatley.
Effects of a synthetic lung surfactant on pharyngeal patency in
awake human subjects. J. Appl.
Physiol. 82(1): 78-85, 1997.
We examined the
effects of separate applications of saline and a synthetic lung
surfactant preparation (Surf; Exosurf Neonatal) into the supraglottic
airway (SA) on the anteroposterior pharyngeal diameter
(Dap) and the
airway pressures required to close (Pcl) and reopen (Pop) the
SA in five awake normal supine subjects. Dap, Pcl, and Pop
were determined during lateral X-ray fluoroscopy and voluntary glottic
closure when pressure applied to the SA lumen was decreased
from 0 to 
20 cmH2O and then
increased to +20 cmH2O. After Surf
application and relative to control,
Dap was larger
for most of the applied pressures, Pcl decreased (12.3 ± 1.9 to 18.7 ± 0.9 cmH2O;
P < 0.01), Pop decreased (13.4 ± 1.9 to 6.0 ± 3.4 cmH2O;
P < 0.01), and genioglossus electromyographic activity did not change (P > 0.05).
Saline had no effect. These observations suggest that pharyngeal
intraluminal surface properties are important in maintaining pharyngeal
patency. We propose that surfactants enhance pharyngeal patency by
reducing surface tension and adhesive forces acting on intraluminal SA
surfaces.
upper airway physiology; closing pressure; opening pressure; surface forces
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