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J Appl Physiol (April 2, 2009). doi:10.1152/japplphysiol.91526.2008
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Submitted on November 24, 2008
Revised on March 31, 2009
Accepted on March 31, 2009

Inspiration regulates the rate and temporal pattern of lung liquid clearance and lung aeration at birth

Melissa Li-Lian Siew1, Megan Jane Wallace1, Marcus John Kitchen1, Robert A. Lewis1, Andreas Fouras1, Arjan B. te Pas2, Naoto Yagi3, Kentaro Uesugi4, Karen K.W. Siu5, and Stuart Brian Hooper1*

1 Monash University
2 Leiden University Medical Center
3 Spring-8/JASRI
4 SPring-8/JASRI
5 Moansh University

* To whom correspondence should be addressed. E-mail: stuart.hooper{at}med.monash.edu.au.

At birth, the initiation of pulmonary gas exchange is dependent on air entry into the lungs and recent evidence indicates that pressures generated by inspiration may be involved. We have used simultaneous plethysmography and phase contrast X-ray imaging to investigate the contribution of inspiration and expiratory braking maneuvers (EBMs) to lung aeration and the formation of a functional residual capacity (FRC) after birth. Near term rabbit pups (n=26) were delivered by caesarean section, placed in a water plethysmograph and imaged during the initiation of spontaneous breathing. Breath-by-breath changes in lung gas volumes were measured using plethysmography and visualized using phase contrast X-ray imaging. Pups rapidly (1-5 breaths) generate a FRC (16.2±1.2ml/kg) by inhaling a greater volume than they expire (by 2.9±0.4 mL/kg/breath over first 5 breaths). As a result, 94.8±1.4% of lung aeration occurred during inspiration over multiple breaths. The incidence of EBMs were rare early during lung aeration, with most (>80%) occurring after >80% of max FRC was achieved. Although EBMs were associated with an overall increase in FRC, 34.8±5.3% of EBMs were associated with a decrease in FRC. We conclude that lung aeration is predominantly achieved by inspiratory efforts and that EBMs help to maintain FRC, following its formation.







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