Journal of Applied Physiology
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J Appl Physiol (October 12, 2001). doi:10.1152/japplphysiol.00582.2001
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Articles in PresS, published online ahead of print October 12, 2001
J Appl Physiol, 10.1152/jap.00582.2001
Submitted on June 6, 2001
Accepted on September 26, 2001

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

Frederic Series1* and Germian Ethier1

1 Centre de recherche de l'Hopital Laval, Hopital Laval, Institut universitaire de cardiologie et de pneumologie de l'Universite Laval, Quebec-city, Quebec, Canada

* To whom correspondence should be addressed. E-mail: frederic.series{at}med.ulaval.ca.

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 twitches expiratory timing (200 ms and 2 s) on UA resistance was studied in 9 normal awake subjects by looking at instantaneous flow, esophageal and pharyngeal pressures, and genioglossal EMG activity during EPNS at baseline and at - 10 cm H2O. The majority of twitches had a flow-limited pattern. Twitches realized at 200 ms and 2 s did not differ in their VImax, but esophageal pressure measured at VImax was significantly less negative with late twitches (- 6.6 ± 2.7 and - 5.0 ± 3.0 cm H2O 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 cm H2O.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.




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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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Discriminative power of phrenic twitch-induced dynamic response for diagnosis of sleep apnea during wakefulness
J Appl Physiol, January 1, 2003; 94(1): 31 - 37.
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