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J Appl Physiol 92: 665-671, 2002. First published October 12, 2001; doi:10.1152/japplphysiol.00582.2001
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Vol. 92, Issue 2, 665-671, February 2002

Site of phrenic nerve stimulation-induced upper airway collapse: influence of expiratory time

F. Sériès and G. Éthier

Centre de Recherche, Hôpital Laval, Institut Universitaire de Cardiologie et de Pneumologie de l'Université Laval, Sainte-Foy, Québec, Canada G1V 4G5

Electrical phrenic nerve stimulation (EPNS) applied at end expiration during exclusive nasal breathing can be used to characterize upper airway (UA) dynamics during wakefulness by dissociating phasic activation of UA and respiratory muscles. The UA level responsible for the EPNS-induced increase in UA resistance is unknown. The influence of the twitch expiratory timing (200 ms and 2 s) on UA resistance was studied in nine normal awake subjects by looking at instantaneous flow, esophageal and pharyngeal pressures, and genioglossal electromyogram (EMG) activity during EPNS at baseline and at -10 cmH2O. The majority of twitches had a flow-limited pattern. Twitches realized at 200 ms and 2 s did not differ in their maximum inspiratory flows, but esophageal pressure measured at maximum inspiratory flow was significantly less negative with late twitches (-6.6 ± 2.7 and -5.0 ± 3.0 cmH2O respectively, P = 0.04). Pharyngeal resistance was higher when twitches were realized at 2 s than at 200 ms (6.4 ± 2.4 and 2.7 ± 1.1 cmH2O · l-1 · s, respectively). EMG activity significant rose at peak esophageal pressure with a greater increase for late twitches. We conclude that twitch-induced UA collapse predominantly occurs at the pharyngeal level and that UA stability assessed by EPNS depends on the expiratory time at which twitches are performed.

maximum inspiratory flow; electrical phrenic nerve stimulation; flow limitation


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F. Series and G. Ethier
Assessment of upper airway stabilizing forces with the use of phrenic nerve stimulation in conscious humans
J Appl Physiol, June 1, 2003; 94(6): 2289 - 2295.
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