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Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine, and Chest Service, Erasme University Hospital, Brussels, Belgium
Submitted 21 June 2004 ; accepted in final form 8 November 2004
Changes in intrathoracic pressure produced by the various inspiratory intercostals are essentially additive, but the interaction between these muscles and the diaphragm remains uncertain. In the present study, this interaction was assessed by measuring the changes in airway opening (
Pao) or transpulmonary pressure (
Ptp) in vagotomized, phrenicotomized dogs during spontaneous inspiration (isolated intercostal contraction), during isolated rectangular or ramp stimulation of the peripheral ends of the transected C5 phrenic nerve roots (isolated diaphragm contraction), and during spontaneous inspiration with superimposed phrenic nerve stimulation (combined diaphragm-intercostal contraction). With the endotracheal tube occluded at functional residual capacity,
Pao during combined diaphragm-intercostal contraction was nearly equal to the sum of the
Pao produced by the two muscle groups contracting individually. However, when the endotracheal tube was kept open,
Ptp during combined contraction was 123% of the sum of the individual
Ptp (P < 0.001). The increase in lung volume during combined contraction was also 109% of the sum of the individual volume increases (P < 0.02). Abdominal pressure during combined contraction was invariably lower than during isolated diaphragm contraction. It is concluded, therefore, that the canine diaphragm and intercostal muscles act synergistically during lung expansion and that this synergism is primarily due to the fact that the intercostal muscles reduce shortening of the diaphragm. When the lung is maintained at functional residual capacity, however, the synergism is obscured because the greater stiffness of the rib cage during diaphragm contraction enhances the
Pao produced by the isolated diaphragm and reduces the
Pao produced by the intercostal muscles.
mechanics of breathing; respiratory muscles
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