Shape of the chest wall in the prone and supine anesthetized dog

The shape of the passive chest wall of six anesthetized dogs was determined at total lung capacity (TLC) and functional residual capacity (FRC) in the prone and supine body positions by use of volumetric-computed tomographic images. The transverse cross-sectional areas of the rib cage, mediastinum, and diaphragm were calculated every 1.6 mm along the length of the thorax. The changes in the volume and the axial distribution of transverse area of the three chest wall components with lung volume and body position were evaluated. The decrease of the transverse area within the rib cage between TLC and FRC, as a fraction of the area at TLC, was uniform from the apex of the thorax to the base. The volume of the mediastinum increased slightly between TLC and FRC (14% of its TLC volume supine and 20% prone), squeezing the lung between it and the rib cage. In the transverse plane, the heart was positioned in the midthorax and moved little between TLC and FRC. The shape, position, and displacement of the diaphragm were described by contour plots. In both postures, the diaphragm was flatter at FRC than at TLC, because of larger displacements in the dorsal than in the ventral region of the diaphragm. Rotation from the prone to supine body position produced a lever motion of the diaphragm, displacing the dorsal portion of the diaphragm cephalad and the ventral portion caudad. In five of the six dogs, bilateral isovolume pneumothorax was induced in the supine body position while intrathoracic gas volume was held constant.(ABSTRACT TRUNCATED AT 250 WORDS)     

Enhancement of signal quality in esophageal recordings of diaphragm EMG

Sinderby, Christer A., Jennifer C. Beck, Lars H. Lindström, and Alejandro E. Grassino. Enhancement of signalquality in esophageal recordings of diaphragm EMG. J. Appl. Physiol. 82(4): 1370-1377, 1997.The cruraldiaphragm electromyogram (EMGdi) is recorded from a sheet of muscle,the fiber direction of which is mostly perpendicular to an esophagealbipolar electrode. The region from which the action potentials areelicited, the electrically active region of the diaphragm(EAR_di) and the center of this region (EAR_{di ctr}) mayvary during voluntary contractions in terms of their position withrespect to an esophageal electrode. Depending on the bipolarelectrode's position with respect to theEAR_{di ctr}, the EMGdi isfiltered to different degrees. The objectives of the present study wereto reduce these filtering effects on the EMGdi by developing ananalysis algorithm referred to as the "double-subtraction technique." The results showed that changes in the position of theEAR_{di ctr} by ±5 mm withrespect to the electrode pairs located 10 mm caudal and 10 mm cephaladprovided a systematic variation in the EMG power spectrumcenter-frequency values by ±10%. The double-subtraction techniquereduced the influence of movement of theEAR_{di ctr} relative to theelectrode array on EMG power spectrum center frequency and root meansquare values, increased the signal-to-noise ratio by 2 dB, andincreased the number of EMG samples that were accepted by the signalquality indexes by 50%.

     

Chest wall mechanics: effects of acute and chronic lung disease

Data from the literature show that lung tissue properties affect the chest wall compliance, Ccw, which is the change in lung volume, Vl, with respect to the pleural pressure, Ppl. to analyze the difference between acute and chronic lung tissue changes, we used a mathematical model that describes the static, nonlinear mechanics of the ventilatory system in terms of its major elements: rib cage; abdomen; diaphragm and lung. With this model we derived the relationship between chest wall, rib-cage and diaphragm compliances. Although the Vl-Ppl relation is independent of lung mechanics, the volume operating point (FRC) of the ventilatory system depends on lung tissue properties. This accounts for the effect of acute lung abnormalities. In the presence of chronic lung abnormalities, the properties of the rib-cage are changed which shifts the entire Vl-Ppl curve. In general, valid comparisons of (extra-pulmonary) chest wall mechanics can only be made using the entire Vl-Ppl relation, or at least a sufficiently large part of the relation about FRC. Differentiation of the rib-cage and diaphragm mechanics requires additional measurements of the rib-cage A-P distance and the relative position of the diaphragm.     

Diaphragmatic contractility after upper abdominal surgery

Postoperative dysfunction of the diaphragm has been reported after upper abdominal surgery. This study was designed to determine whether an impairment in diaphragmatic contractility was involved in the genesis of the diaphragmatic dysfunction observed after upper abdominal surgery. Five patients undergoing upper abdominal surgery were studied. The following measurements were performed before and 4 h after surgery: vital capacity (VC), functional residual capacity (FRC), and forced expiratory volume in 1 s. Diaphragmatic function was also assessed using the ratio of changes in gastric pressure (delta Pga) over changes in transdiaphragmatic pressure (delta Pdi). Finally contractility of the diaphragm was determined by measuring the change in delta Pdi generated during bilateral electrical stimulation of the phrenic nerves (Pdi stim). Diaphragmatic dysfunction occurred in all the patients after upper abdominal surgery as assessed by a marked decrease in delta Pga/delta Pdi from 0.480 +/- 0.040 to -0.097 +/- 0.152 (P less than 0.01) 4 h after surgery compared with preoperative values. VC also markedly decreased after upper abdominal surgery from 3,900 +/- 630 to 2,060 +/- 520 ml (P less than 0.01) 4 h after surgery. In contrast, no change in FRC and Pdi stim was observed 4 h after surgery. In contrast, no change in FRC and Pdi stim was observed 4 h after upper abdominal surgery compared with the preoperative values. We conclude that contractility of the diaphragm is not altered after upper abdominal surgery, and diaphragmatic dysfunction is secondary to other mechanisms such as possible reflexes arising from the periphery (chest wall and/or peritoneum), which could inhibit the phrenic nerve output.     

Functional and Morphological Assessment of Diaphragm Innervation by Phrenic Motor Neurons

This protocol specifically focuses on tools for assessing phrenic motor neuron (PhMN) innervation of the diaphragm at both the electrophysiological and morphological levels. Compound muscle action potential (CMAP) recording following phrenic nerve stimulation can be used to quantitatively assess functional diaphragm innervation by PhMNs of the cervical spinal cord in vivo in anesthetized rats and mice. Because CMAPs represent simultaneous recording of all myofibers of the whole hemi-diaphragm, it is useful to also examine the phenotypes of individual motor axons and myofibers at the diaphragm NMJ in order to track disease- and therapy-relevant morphological changes such as partial and complete denervation, regenerative sprouting and reinnervation. This can be accomplished via whole-mount immunohistochemistry (IHC) of the diaphragm, followed by detailed morphological assessment of individual NMJs throughout the muscle. Combining CMAPs and NMJ analysis provides a powerful approach for quantitatively studying diaphragmatic innervation in rodent models of CNS and PNS disease.     

Diaphragm EMG measured by cervical magnetic and electrical phrenic nerve stimulation

The purpose of the study was to compareelectrical stimulation (ES) and cervical magnetic stimulation (CMS) ofthe phrenic nerves for the measurement of the diaphragm compound muscleaction potential (CMAP) and phrenic nerve conduction time. A specially designed esophageal catheter with three pairs of electrodes was used,with control of electrode positioning in 10 normal subjects. Pair A and pairB were close to the diaphragm (pairA lower than pairB); pair C waspositioned 10 cm above the diaphragm to detect the electromyogram fromextradiaphragmatic muscles. Electromyograms were also recorded fromupper and lower chest wall surface electrodes. The shape of the CMAPmeasured with CMS (CMS-CMAP) usually differed from that of the CMAPmeasured with ES (ES-CMAP). Moreover, the latency of theCMS-CMAP from pair B (5.3 ± 0.4 ms) was significantly shorter than that from pairA (7.1 ± 0.7 ms). The amplitude of the CMS-CMAP(1.00 ± 0.15 mV) was much higher than that of ES-CMAP (0.26 ± 0.15 mV) when recorded from pair C.Good-quality CMS-CMAPs could be recorded in some subjects from anelectrode positioned very low in the esophagus. The differences betweenES-CMAP and CMS-CMAP recorded either from esophageal or chest wallelectrodes make CMS unreliable for the measurement of phrenic nerveconduction time.

     

Effect of inflation on the interaction between the left and right hemidiaphragms.

At resting end expiration [functional residual capacity (FRC)], the actions of the left and right hemidiaphragms on the lung are synergistic. However, the synergism decreases in magnitude as muscle tension decreases. Therefore, the hypothesis was tested in anesthetized dogs that the degree of synergism between the two hemidiaphragms also decreases with increasing lung volume. In a first experiment, the changes in airway opening pressure (DeltaPao) and abdominal pressure (DeltaPab) obtained during simultaneous stimulation of the left and right phrenic nerves (measured changes in pressure) at different lung volumes were compared with the sum of the pressure changes produced by their separate stimulation (predicted changes in pressure). Although the pressure changes decreased markedly with increasing lung volume, the measured DeltaPao and DeltaPab were substantially greater than the predicted values at all lung volumes. The ratio of the measured to the predicted DeltaPao, in fact, remained constant. In a second experiment, radiographic measurements showed that the fractional shortening of the muscle during bilateral contraction at high lung volumes was similar to that during unilateral contraction. During unilateral contraction at high lung volumes, however, the passive hemidiaphragm moved in the cranial direction, whereas, during unilateral contraction at FRC, it moved in the caudal direction. These observations indicate that 1) for a given muscle tension, the synergism between the two halves of the diaphragm is greater at high lung volumes than at FRC; and 2) this difference is primarily related to the greater distortion of the muscle configuration.     

Respiratory load compensation in chronic airway obstruction

To assess respiratory neuromuscular function and load compensating ability in patients with chronic airway obstruction (CAO), we studied eight stable patients with irreversible airway obstruction during hyperoxic CO2 rebreathing with and without a 17 cmH2O X l-1 X s flow-resistive inspiratory load (IRL). Minute ventilation (VE), transdiaphragmatic pressure (Pdi), and diaphragmatic electromyogram (EMGdi) were monitored. Pdi and EMGdi were obtained via a single gastroesophageal catheter with EMGdi being quantitated as the average rate of rise of inspiratory (moving average) activity. Based on the effects of IRL on the Pdi response to CO2 [delta Pdi/delta arterial CO2 tension (PaCO2)] and the change in Pdi for a given change in EMGdi (delta Pdi/delta EMGdi) during rebreathing, two groups could be clearly identified. Four patients (group A) were able to increase delta Pdi/delta PaCO2 and delta Pdi/delta EMGdi, whereas in the other four (group B) the IRL responses decreased. All group B patients were hyperinflated having significantly greater functional residual capacity (FRC) and residual volume than group A. In addition the IRL induced percent change in delta Pdi/delta PaCO2, and delta VE/delta PaCO2 was negatively correlated with lung volume so that in the hyperinflated group B the higher the FRC the greater was the decrease in Pdi response due to IRL. In both groups the greater the FRC the greater was the decrease in the ventilatory response to loading. Patients with CAO, even with severe airways obstruction, can effect load compensation by increasing diaphragmatic force output, but the presence of increased lung volume with the associated shortened diaphragm prevents such load compensation.     

Human diaphragmatic EMG: changes with lung volume and posture during supramaximal phrenic stimulation

If esophageal and chest wall recordings of diaphragmatic electromyographic activity (EMG) accurately reflect neural drive to this muscle, then compound muscle action potentials (CMAPs) produced by supramaximal stimulation of the phrenic nerve should not alter with changes in diaphragmatic position. Maximal CMAPs were therefore recorded 1) during changes in lung volume from near residual volume to near total lung capacity, 2) during isovolume maneuvers at different lung volumes, and 3) while subjects were lying, sitting, and standing. The areas of maximal CMAPs recorded with the gastroesophageal catheter increased 5.1 +/- 3.6 times (mean +/- SD) between these volumes, increased 2.4 +/- 1.3 times as the diaphragm descended during an isovolume maneuver (at functional residual capacity), and increased 4.4 +/- 2.4 times between the lying and standing positions. Because the stimuli were supramaximal, these changes in EMG reflect changes in the relationship between the esophageal electrodes and the diaphragmatic muscle fibers. Artifactual changes were also documented for surface electrodes on the chest wall. Because of these positional changes in maximal CMAPs, previous studies, which used integrated diaphragmatic EMG to document "reflex" changes in neural drive, should be reevaluated.     

Length and curvature of the dog diaphragm.

Transdiaphragmatic pressure is a result of both tension in the muscles of the diaphragm and curvature of the muscles. As lung volume increases, the pressure-generating capability of the diaphragm decreases. Whether decrease in curvature contributes to the loss in transdiaphragmatic pressure and, if so, under what conditions it contributes are unknown. Here we report data on muscle length and curvature in the supine dog. Radiopaque markers were attached along muscle bundles in the midcostal region of the diaphragm in six beagle dogs of approximately 8 kg, and marker locations were obtained from biplanar images at functional residual capacity (FRC), during spontaneous inspiratory efforts against a closed airway at lung volumes from FRC to total lung capacity, and during bilateral maximal phrenic nerve stimulation at the same lung volumes. Muscle length and curvature were obtained from these data. During spontaneous inspiratory efforts, muscle shortened by 15-40% of length at FRC, but curvature remained unchanged. During phrenic nerve stimulation, muscle shortened by 30 to nearly 50%, and, for shortening exceeding 52%, curvature appeared to decrease sharply. We conclude that diaphragm curvature is nearly constant during spontaneous breathing maneuvers in normal animals. However, we speculate that it is possible, if lung compliance were increased and the chest wall and the diameter of the diaphragm ring of insertion were enlarged, as in the case of chronic obstructive pulmonary disease, that decrease in diaphragm curvature could contribute to loss of diaphragm function.     

Crural diaphragm activation during dynamic contractions at various inspiratory flow rates

The purpose of this study was to evaluate the influence ofvelocity of shortening on the relationship between diaphragm activation and pressure generation in humans. This was achieved by relating theroot mean square (RMS) of the diaphragm electromyogram to thetransdiaphragmatic pressure (Pdi) generated during dynamic contractionsat different inspiratory flow rates. Five healthy subjects inspiredfrom functional residual capacity to total lung capacity at differentflow rates while reproducing identical Pdi and chest wall configurationprofiles. To change the inspiratory flow rate, subjects performed theinspirations while breathing across two different inspiratoryresistances (10 and 100 cmH₂O · l¹ · s),at mouth pressure targets of 10, 20, 40, and60 cmH₂O. The diaphragmelectromyogram was recorded and analyzed with control of signalcontamination and electrode positioning. RMS values obtained forinspirations with identical Pdi and chest wall configuration profileswere compared at the same percentage of inspiratory duration. Atinspiratory flows ranging between 0.1 and 1.4 l/s, there was nodifference in the RMS for the inspirations from functional residualcapacity to total lung capacity when Pdi and chest wall configurationprofiles were reproduced (n = 4). Athigher inspiratory flow rates, subjects were not able to reproducetheir chest wall displacements and adopted different recruitmentpatterns. In conclusion, there was no evidence for increased demand ofdiaphragm activation when healthy subjects breathe with similar chestwall configuration and Pdi profiles, at increasing flow rates up to 1.4 l/s.

     

Multichannel surface electrodes increase the sensitivity of diagnosis of neuropathy in diabetic patients

This prospective study investigated the diagnostic sensitivity of a novel multichannel surface electrode for detecting electrophysiologic changes in symptomatic diabetic neuropathy. We recruited healthy subjects without neuropathic complaints and diabetic patients with distal symmetric sensory symptoms who had normal nerve conduction studies (NCS). Eight compound muscle action potentials (CMAPs) were recorded using a multichannel electrode from each subject’s abductor pollicis brevis muscle by stimulating the median nerve at the wrist. Latency- and amplitude-related variables were obtained and analyzed to compare the two groups. We used the Classification and Regression Tree (CART) algorithm to determine the cut-off values for selected predictors of diabetic neuropathy. All of the variables related to CMAP latency showed statistically significant differences between the median values for the diabetic group and the healthy control group. For example, the median value of the maximum latency and standard deviation of the eight CMAP onset latencies in diabetic patients (3.82 ms and 0.15 ms, respectively) were significantly larger than those in controls (3.26 ms and p < 0.001; 0.09 ms and p < 0.001, respectively). The CART analysis revealed that these variables were the most sensitive and specific variables for discriminating between patients with diabetic neuropathy and normal subjects. The multichannel surface electrode demonstrated both high sensitivity and specificity in detecting neurophysiologic abnormality of diabetic neuropathy, even when conventional NCS did not detect the abnormality.     

Regional ventilation during spontaneous breathing and mechanical ventilation in dogs

We evaluated the effects of the different patterns of chest wall deformation that occur with different body positions and modes of breathing on regional lung deformation and ventilation. Using the parenchymal marker technique, we determined regional lung behavior during mechanical ventilation and spontaneous breathing in five anesthetized recumbent dogs. Regional lung behavior was related to the patterns of diaphragm motion estimated from X-ray projection images obtained at functional residual capacity (FRC) and end inspiration. Our results indicate that 1) in the prone and supine positions, FRC was larger during mechanical ventilation than during spontaneous breathing; 2) there were significant differences in the patterns of diaphragm motion and regional ventilation between mechanical ventilation and spontaneous breathing in both body positions; 3) in the supine position only, there was a vertical gradient in lung volume at FRC; 4) in both positions and for both modes of breathing, regional ventilation was nonlinearly related to changes in lobar and overall lung volumes; and 5) different patterns of diaphragm motion caused different sliding motions and differential rotations of upper and lower lobes. Our results are inconsistent with the classic model of regional ventilation, and we conclude that the distribution of ventilation is determined by a complex interaction of lung and chest wall shapes and by the motion of the lobes relative to each other, all of which help to minimize distortion of the lung parenchyma.     

Phrenic afferent contribution to reflexes elicited by changes in diaphragm length

Recent evidence from several laboratories suggests that activation of afferents in the diaphragm can reflexly affect inspiratory muscle activation. This study determined whether afferents in the diaphragm contribute to compensatory changes in phrenic motor drive when the operating length of the diaphragm is suddenly increased. Experiments were performed in six closed-chest pentothal-anesthetized cats. Length changes were measured using a pair of piezoelectric crystals implanted in the left crural diaphragm. The crural electromyogram (EMGdi) was measured by electrodes fixed to each crystal. The animal was suspended in a spinal frame, and a Plexiglas tube was fitted around the cat's abdomen. A balloon placed inside the tube was inflated during the expiratory phase to produce a mean increase of 17% in diaphragm length at functional residual capacity. Ten trials were performed in succession under the following conditions: intact, after bilateral vagotomy, after spinal section at C7, and after cervical dorsal rhizotomy. Peak integrated EMGdi (integral of EMGdi) and neural inspiratory time (nTI) were measured for the last control inspiration and the first after inflation. There was a significant reduction in the peak integral of EMGdi when the length of the diaphragm was increased for all conditions except after rhizotomy. Although not measured, it is likely that the tension developed by the diaphragm was also increased during abdominal compression. Results suggest that afferents sensitive to changes in the operating length and/or tension in the diaphragm contribute to compensatory alterations in phrenic motor drive.     

Effect of chest wall vibration on breathlessness in normal subjects

This study evaluated the effect of chest wall vibration (115 Hz) on breathlessness. Breathlessness was induced in normal subjects by a combination of hypercapnia and an inspiratory resistive load; both minute ventilation and end-tidal CO2 were kept constant. Cross-modality matching was used to rate breathlessness. Ratings during intercostal vibration were expressed as a percentage of ratings during the control condition (either deltoid vibration or no vibration). To evaluate their potential contribution to any changes in breathlessness, we assessed several aspects of ventilation, including chest wall configuration, functional residual capacity (FRC), and the ventilatory response to steady-state hypercapnia. Intercostal vibration reduced breathlessness ratings by 6.5 +/- 5.7% compared with deltoid vibration (P less than 0.05) and by 7.0 +/- 8.3% compared with no vibration (P less than 0.05). The reduction in breathlessness was accompanied by either no change or negligible change in minute ventilation, tidal volume, frequency, duty cycle, compartmental ventilation, FRC, and the steady-state hypercapnic response. We conclude that chest wall vibration reduces breathlessness and speculate that it may do so through stimulation of receptors in the chest wall.     

Effects of lung volume on diaphragm EMG signal strength during voluntary contractions

The use ofesophageal recordings of the diaphragm electromyogram (EMG) signalstrength to evaluate diaphragm activation during voluntary contractionsin humans has recently been criticized because of a possible artifactcreated by changes in lung volume. Therefore, the first aim of thisstudy was to evaluate whether there is an artifactual influence of lungvolume on the strength of the diaphragm EMG during voluntarycontractions. The second aim was to measure the required changes inactivation for changes in lung volume at a given tension, i.e., thevolume-activation relationship of the diaphragm. Healthy subjects(n = 6) performed contractions of thediaphragm at different transdiaphragmatic pressure (Pdi) targets (range20-160 cmH₂O) whilemaintaining chest wall configuration constant at different lungvolumes. The diaphragm EMG was recorded with a multiple-arrayesophageal electrode, with control of signal contamination andelectrode positioning. The effects of lung volume on the EMG werestudied by comparing the crural diaphragm EMG root mean square (RMS),an index of crural diaphragm activation, with an index of globaldiaphragm activation obtained by normalizing Pdi to the maximum Pdi atthe given muscle length(Pdi/Pdi_max@L) at thedifferent lung volumes. We observed a direct relationship between RMSand Pdi/Pdi_max@L independent of diaphragm length. The volume-activation relationship ofthe diaphragm was equally affected by changes in lung volume as thevolume-Pdi relationship (60% change from functional residual capacityto total lung capacity). We conclude that the RMS of the diaphragm EMGis not artifactually influenced by lung volume and can be used as areliable index of diaphragm activation. The volume-activationrelationship can be used to infer changes in the length-tensionrelationship of the diaphragm at submaximal activation/contractionlevels.

     

Nonchemical influence of inspiratory pressure support on inspiratory activity in humans

To determinewhether nonchemical inhibition of respiratory activity occurs duringinspiratory pressure support (IPS) ventilation (IPSV), respiratorymotor output (in 9 subjects), obtained by calculatingtransdiaphragmatic pressure-time products, and central respiratoryoutput (in 5 subjects), obtained by integrating the electromyographicactivity of the diaphragm (EMGdi) during mechanical inspiratory time,EMGdi per minute, and electrical inspiratory time, asdetermined from onset to peak EMGdi, were compared during spontaneous ventilation (control) and IPSV with(IPS+CO₂) and without (IPS)correction of hypocapnia. Both IPS andIPS+CO₂ induced significantdecreases in transdiaphragmatic pressure-time products (46 ± 31 and53 ± 23%, respectively), EMGdi during mechanical inspiratory time(49 ± 12 and 57 ± 14%, respectively), EMGdi per minute (65 ± 22 and 69 ± 15%, respectively), andelectrical inspiratory time (73 ± 8 and 65 ± 6%,respectively). Because correction of hypocapnia failed to eliminate themarked inhibition of both respiratory and central motor output seenwith IPS, we conclude that nonchemical inhibition of respiratoryactivity occurs during IPSV.

     

Time domain analysis of diaphragmatic electromyogram during fatigue in men

Diaphragmatic fatigue has been correlated with a change in the electromyogram recorded from the diaphragm (EMGdi), which suggests that the electromyogram is a potential clinical tool to detect respiratory muscle fatigue. Changes in the EMGdi have previously been quantified by using the power spectral parameters high-low ratio or mean frequency. In this study, we developed an autoregressive model of the EMG in an attempt to improve the analysis of the EMGdi. This model was tested on recordings of the EMGdi that were obtained from an esophageal electrode in five normal subjects breathing to fatigue through an inspiratory resistor. The data obtained from the autoregressive model were directly compared with data from the high-low ratio and mean frequency techniques. The autoregressive model showed an excellent correlation with mean frequency. Both techniques were superior to the high-low ratio measurement. Because the autoregressive model requires much less computation than mean frequency and can be easily implemented in real time on a minicomputer, we propose this as a preferable approach.     

Diaphragm curvature modulates the relationship between muscle shortening and volume displacement

During physiological spontaneous breathing maneuvers, the diaphragm displaces volume while maintaining curvature. However, with maximal diaphragm activation, curvature decreases sharply. We tested the hypotheses that the relationship between diaphragm muscle shortening and volume displacement (VD) is nonlinear and that curvature is a determinant of such a relationship. Radiopaque markers were surgically placed on three neighboring muscle fibers in the midcostal region of the diaphragm in six dogs. The three-dimensional locations were determined using biplanar fluoroscopy and diaphragm VD, curvature, and muscle shortening were computed in the prone and supine postures during spontaneous breathing (SB), spontaneous inspiration efforts after airway occlusion at lung volumes ranging from functional residual capacity (FRC) to total lung capacity, and during bilateral maximal phrenic nerve stimulation at those same lung volumes. In supine dogs, diaphragm VD was approximately two- to three-fold greater during maximal phrenic nerve stimulation than during SB. The contribution of muscle shortening to VD nonlinearly increases with level of diaphragm activation independent of posture. During submaximal diaphragm activation, the contribution is essentially linear due to constancy of diaphragm curvature in both the prone and supine posture. However, the sudden loss of curvature during maximal bilateral phrenic nerve stimulation at muscle shortening values greater than 40% (ΔL/L(FRC)) causes a nonlinear increase in the contribution of muscle shortening to diaphragm VD, which is concomitant with a nonlinear change in diaphragm curvature. We conclude that the nonlinear relationship between diaphragm muscle shortening and its VD is, in part, due to a loss of its curvature at extreme muscle shortening.     

Lung volumes, chest wall configuration, and pattern of breathing in microgravity

We studied the changes in functional residual capacity (FRC), thoracoabdominal volume (Vw), and chest wall configuration in five normal subjects seated in an aircraft flying parabolic trajectories resulting in 20-s periods of microgravity. We measured vital capacity (VC), inspiratory capacity, and tidal volume by integrating airflow at the mouth and changes in rib cage and abdominal volume (delta Vrc and delta Vab, respectively, where delta Vrc + delta Vab = delta Vw) using induction plethysmography. During microgravity (0 Gz) FRC decreased by 413 +/- 70 (SE) ml and VC by 0.37 liter. The decrease in Vw did not differ from that in FRC and was entirely the result of reduction of Vab, the Vrc showing no significant change. During tidal breathing the abdominal contribution (delta Vab/delta Vw) increased from 0.39 +/- 0.08 at 1 Gz to 0.57 +/- 0.08 at 0 Gz. During brief periods of hypergravity (approximately 1.8 Gz) all changes were opposite in sign and relatively smaller. Limited data during "roller coaster" flight patterns suggested that, in contrast to configurational changes, the temporal pattern of breathing was uninfluenced by changes in Gz. We conclude that at the onset of weightlessness there are substantial changes in lung volume and thoracoabdominal configuration. Abdominal contribution to tidal excursions increases but the temporal pattern of breathing is unchanged.