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1 Ludwig Engel Centre for Respiratory Research, Westmead Hospital, Sydney, NSW, Australia; University of Sydney, Sydney, NSW, Australia
2 University of Sydney, Sydney, NSW, Australia
* To whom correspondence should be addressed. E-mail: kristinak{at}westgate.wh.usyd.edu.au.
Transmural pressure at any level in the upper airway is dependent on the difference between intraluminal airway and extraluminal tissue pressure (ETP). We hypothesised that ETP would be affectd by topography, head/neck position, resistive loading and stimulated breathing on ETP in rabbits. Methods: Twenty eight male, NZ White, anesthetised, spontaneously breathing rabbits breathed via a face mask with attached pneumotachograph to measure airflow (V) and pressure transducer to monitor mask pressure (PM). Tidal volume (VT) was measured via integration of the V signal. ETP was measured with a pressure transducer tipped catheter inserted in the tissues of the lateral (ETPlat, n=28) and anterior (ETPant, n=21), pharyngeal wall. Head position was controlled at 30°, 50° or 70° and the effect of addition of an external resistor, brief occlusion, or stimulated breathing examined. Results: Mean ETPlat was ~0.7 cm H2O greater than mean ETPant when adjusted for degree of head/neck flexion (p<0.05). Mean, maximum and minimum ETP values increased significantly by 0.7 to 0.8 cmH2O per 20° of head/neck flexion when adjusted for site of measurement (p<0.0001). The main effect of resistive loading/occlusion was an increase in 
ETPlat (maximum-minimum ETPlat) and ETPant at all head/neck positions (p<0.05). Mean ETPlat and ETPant increased with increasing tidal volume at head/neck position 30° (all p<0.05). Conclusion: ETP was non-homogeneously distributed around the upper airway and increased with both increasing head/neck flexion and increasing VT. Brief airway occlusion increased the size of respiratory related ETP fluctuations in upper airway ETP.
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