Cardiovascular and respiratory responses to right atrial injections of phenyl diguanide in pentobarbital-anesthetized newborn piglets

Development of mechanics and pulmonary reflexes

The mechanical properties of the respiratory system are paramount in converting neural output into ventilation. The highly compliant chest wall of the newborn results in chest distortion and volume loss during inspiration and, as the chest is also unable to resist the inward recoil of the lung, there is a reduction in lung volume at end expiration (functional residual capacity) and a tendency for alveoli to collapse. Vagal innervation of the lungs and airways is responsible for eliciting various reflexes that result in the dynamic modification of respiratory mechanics and an improvement in ventilation. From the first breath, the newborn increases the frequency of augmented breaths to improve lung compliance and prolongs the expiratory time constant in order to increase the amount of air remaining in the lung at end expiration and help prevent lung collapse. This review examines the respiratory mechanics of the mammalian neonate at birth and during early development together with the vagal reflexes that are responsible for the dynamic modification of respiratory mechanics in order to ensure that effective gas exchange occurs from birth.

Influence of maturation on constrictive response to stimulation of C-fiber afferents in isolated guinea pig airways

We investigated whether the airway constrictive response to stimulation of bronchopulmonary C-fiber afferents is altered during the maturation process. Isometric tension was measured in airway rings isolated from three tracheobronchial locations (intrathoracic trachea and main and hilar bronchi) and compared in mature [M, 407 ± 10 (SE) g body wt, n = 36] and immature (IM, 161 ± 5 g body wt, n = 35) guinea pigs. Our results showed no difference in the ACh (10−5 M)- or KCl (40 mM)-induced contraction between M and IM groups, regardless of the airway location. In sharp contrast, the concentration-response curves of 10−8–10−6 M capsaicin were distinctly lower in IM hilar bronchi; for example, response to the same concentration of capsaicin (10−6 M) was 89.2 ± 15.3% of the response to 10−5 M ACh in IM and 284.7 ± 43.2% in M animals. Similar, but smaller, differences in the bronchoconstrictive response to capsaicin between IM and M groups were also observed in the trachea and main bronchus. Electrical field stimulation induced airway constriction in all three locations in M and IM groups. However, after administration of 10−6 M atropine and 10−6 M propranolol, electrical field stimulation-induced contraction was significantly smaller in the hilar bronchus of IM than M animals, and this difference was not prevented by pretreatment with 5 × 10−5 M indomethacin. Although radioimmunoassay showed no difference in the tissue content of substance P between M and IM airways, the constrictive responses to exogenous substance P and neurokinin A were markedly greater in M airways at all three locations. In conclusion, the constriction of isolated airways evoked by C-fiber stimulation was significantly weaker in the IM guinea pigs, probably because of a less potent effect of tachykinins on the airway smooth muscle.

Postnatal maturation of vagal respiratory reflexes in preterm and full-term lambs

The postnatal development of ventilatory reflexes originating from bronchopulmonary receptors was assessed in preterm vs. full-term lambs. Ventilation and arterial pressure were repeatedly measured in 10 preterm (gestational age, 132 days) and 7 full-term lambs without sedation from day 1 to day 42. The Hering-Breuer inhibitory reflex (slowly adapting stretch receptors) was assessed by the increase in expiratory time during end-inspiratory occlusion. The pulmonary chemoreflex (C-fiber endings) was assessed by the initial apnea + bradycardia + systemic hypotension and the secondary tachypnea after capsaicin intravenous injection. Results show the following. 1) Premature birth did not modify the maturation of the Hering-Breuer reflex. 2) Whereas a classic pulmonary chemoreflex was observed in the very first hours of life in preterm lambs, the tachypneic component of this reflex was weaker than in full-term lambs on day 1. 3) Premature birth led to a reversed postnatal maturation of this tachypneic response (tendency to increase with postnatal age). Our findings suggest that premature birth in lambs modifies postnatal maturation of the pulmonary chemoreflex.

Age-related effects of cardiac sympathetic denervation on the responses to cardiopulmonary receptor stimulation in piglets

The effects of right stellate ganglionectomy (RSG) and bilateral stellate ganglionectomy (BSG) on cardiovascular responses to phenyl biguanide (PBG, 80 micrograms/kg) were studied in 1- and 8-wk-old piglets. Animals were anesthetized with Saffan, paralyzed, thoractomized, and ventilated with 100% O2. Recordings of the ECG (lead II) and aortic pressure (AoP) were used to compute the maximum R-R interval, heart rate (HR), and mean AoP, and to determine the occurrence of atrioventricular conduction block (AVB). Right atrial injections of PBG in 1-wk-old piglets elicited AVB as well as decreases in AoP and HR in all animals; this response pattern was not altered by either RSG or BSG. The PBG response of neurally intact 8-wk-old animals was comprised of a decrease of HR without change in AoP; AVB occurred in three of six animals. After RSG or BSG, AoP decreased along with decreased HR, and now AVB occurred in all animals; changes of AoP and maximum R-R interval were greater after BSG than after RSG. These results suggest that the stellate ganglia exert a neuroprotective influence on cardiovascular function, requiring some degree of maturation for expression. Our findings support the hypothesis that an imbalance of cardiac autonomic innervation favoring parasympathetic activity may produce immature responses to cardiopulmonary afferent stimulation in older maturing animals.

Capsaicin-induced reflex bronchoconstriction in the newborn

Although bronchoconstriction in response to C-fibre stimulation has been reported to be weak or absent in the newborn, pulmonary resistance and compliance have not been measured. We tested the hypothesis that capsaicin reflexly activates pulmonary efferent outflow to airway smooth muscle in the newborn. We measured breath-by-breath responses of inspiratory lung resistance (RLi) and dynamic compliance (CLdyn) in 13 newborn dogs and 4 newborn pigs during right heart injections of saline, capsaicin (25-50 micrograms/kg) and acetylcholine (ACh). Repeat capsaicin injections at 5 min intervals were made to test for desensitization in the newborn dog. All newborn dogs and 2 of 4 newborn pigs displayed a brisk bronchoconstriction; in the dog, RLi increased maximally by 97% +/- 13 (SE) and CLdyn decreased maximally by 32% +/- 2. In both species, initial capsaicin injections (CAP1) caused a long latency (time to peak heart rate 26.8 +/- 2 and 20 sec +/- 2.5) increase in heart rate (40% +/- 11 and 20.1% +/- 8.2 for the newborn dog and pig respectively). In the dog, but not the pig, capsaicin responses after the ACh trial (CAP2 and CAP3) caused a short latency bradycardia while the long latency tachycardia continued to be expressed in both species. The maximal changes in RLi and CLdyn, and the bradycardia, were reduced (i.e. desensitized) by 36%, 53% and 63% respectively if capsaicin injection was repeated within 5 min. Muscarinic blockade with atropine abolished the bronchoconstrictor and bradycardia responses to capsaicin but had no effect on the tachycardia. We conclude that the newborn possesses the neural circuitry to mount a bronchoconstrictor response to C-fibre stimulation. We speculate that the response is designed to reduce dead space and stabilize highly compliant airways of the newborn during the rapid shallow breathing that is typically associated with C-fibre stimulation.

Brainstem cells of origin of the cervical vagus and cardiopulmonary nerves in the neonatal pig (Sus scrofa)

The distribution of the cells of origin of the cervical vagus and cardiopulmonary nerves has been studied in neonatal piglets (Sus scrofa) ranging in age from 1 to 60 days. Cardiopulmonary nerves were identified physiologically and anatomically prior to injection of horseradish peroxidase (HRP) into the nerves. Following injection of HRP into the cervical vagus nerve retrogradely labeled neurons were present in the dorsal motor nucleus of the vagus nerve (DMV), the nucleus of the solitary tract, the nucleus ambiguus (NA), ventrolateral to the NA and in an intermediate zone between the DMV and the NA. Two unique clusters of neurons were also retrogradely labeled after injections into the vagus nerve. One group was located lateral to the most caudal levels of the DMV and extended as far caudally as the C1 spinal segment. The second distinctive group was located ventrolateral to the nucleus ambiguus in a cell column identified as the ventrolateral nucleus ambiguus (VLNA). After injections of HRP into cardiopulmonary nerves, the majority of neurons were found in the VLNA and the distinct clusters of neurons in this cell column were particularly heavily labeled. Small numbers of cells were labeled in the DMV and NA and none were labeled in the solitary nucleus after cardiopulmonary nerve injections. There were no apparent age-related differences in the degree or distribution of retrograde labeling. The distribution of neurons in the medulla oblongata projecting into cardiopulmonary nerves in the piglet is similar to that described in other species, i.e., the nucleus ambiguus, particularly its ventrolateral cell column, is the primary site of cardiomotor neurons. In addition, in the piglet there is a morphologically distinct cluster of cells related to the heart, and possibly the lungs, which does not appear to be present in other species.