1
|
Virsilas E, Liubsys A, Janulionis A, Valiulis A. Noninvasive Respiratory Support Effects on Sighs in Preterm Infants by Electrical Impedance Tomography. Indian J Pediatr 2022:10.1007/s12098-022-04413-8. [PMID: 36539568 DOI: 10.1007/s12098-022-04413-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate differences regarding sigh frequency between noninvasive respiratory support types and to assess regional ventilation distribution, delta Z, and end-expiratory lung impedance differences before and after sighs. METHODS Very low-birth-weight infants with gestational ages less than 32 wk were included in the study. Participants were split into two groups: those receiving continuous positive airway pressure and infants receiving high-flow nasal cannula therapy. RESULTS The study enrolled 30 infants. The high-flow nasal cannula therapy group had more sighs per 10-min period than infants receiving continuous positive airway pressure (p = 0.016). Ventilation distribution was similar in the anterior and right ventilation distribution compartments pre- and post-sigh (46.30% vs. 45.68% and 54.27% vs. 55.26%, respectively). No statistically significant increase in end-expiratory lung impedance or delta Z was observed in global or separate lung regions (p > 0.05). CONCLUSION The study has demonstrated that sighs are more frequent in infants receiving high-flow nasal cannula respiratory support compared to continuous positive airway pressure. Spontaneously occurring sighs on noninvasive respiratory support due to respiratory distress syndrome (RDS) do not increase end-expiratory lung impedance or alter delta Z, and appear to have limited clinical significance. TRIAL REGISTRATION Prospectively registered at www. CLINICALTRIALS gov , reg. No. NCT04542096, reg. date 01/09/2020.
Collapse
Affiliation(s)
- Ernestas Virsilas
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių G. 7, 08406, Vilnius, Lithuania.
| | - Arunas Liubsys
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių G. 7, 08406, Vilnius, Lithuania
| | - Adomas Janulionis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių G. 7, 08406, Vilnius, Lithuania
| | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Santariškių G. 7, 08406, Vilnius, Lithuania
| |
Collapse
|
2
|
Li C, Ren Q, Li X, Han H, Peng M, Xie K, Wang Z, Wang G. Effect of sigh in lateral position on postoperative atelectasis in adults assessed by lung ultrasound: a randomized, controlled trial. BMC Anesthesiol 2022; 22:215. [PMID: 35820814 PMCID: PMC9275275 DOI: 10.1186/s12871-022-01748-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/02/2022] [Indexed: 11/16/2022] Open
Abstract
Background Postoperative atelectasis occurs in 90% of patients receiving general anesthesia. Recruitment maneuvers (RMs) are not always effective and frequently associated with barotrauma and hemodynamic instability. It is reported that many natural physiological behaviors interrupted under general anesthesia could prevent atelectasis and restore lung aeration. This study aimed to find out whether a combined physiological recruitment maneuver (CPRM), sigh in lateral position, could reduce postoperative atelectasis using lung ultrasound (LUS). Methods We conducted a prospective, randomized, controlled trial in adults with open abdominal surgery under general anesthesia lasting for 2 h or longer. Subjects were randomly allocated to either control group (C-group) or CPRM-group and received volume-controlled ventilation with the same ventilator settings. Patients in CPRM group was ventilated in sequential lateral position, with the addition of periodic sighs to recruit the lung. LUS scores, dynamic compliance (Cdyn), the partial pressure of arterial oxygen (PaO2) and fraction of inspired oxygen (FiO2) ratio (PaO2/FiO2), and other explanatory variables were acquired from each patient before and after recruitment. Results Seventy patients were included in the analysis. Before recruitment, there was no significant difference in LUS scores, Cdyn and PaO2/FiO2 between CPRM-group and C-group. After recruitment, LUS scores in CPRM-group decreased significantly compared with C-group (6.00 [5.00, 7.00] vs. 8.00 [7.00, 9.00], p = 4.463e-11 < 0.05), while PaO2/FiO2 and Cdyn in CPRM-group increased significantly compared with C-group respectively (377.92 (93.73) vs. 309.19 (92.98), p = 0.008 < 0.05, and 52.00 [47.00, 60.00] vs. 47.70 [41.00, 59.50], p = 6.325e-07 < 0.05). No hemodynamic instability, detectable barotrauma or position-related complications were encountered. Conclusions Sigh in lateral position can effectively reduce postoperative atelectasis even without causing severe side effects. Further large-scale studies are necessary to evaluate it’s long-term effects on pulmonary complications and hospital length of stay. Trial registration ChiCTR1900024379. Registered 8 July 2019, Supplementary Information The online version contains supplementary material available at 10.1186/s12871-022-01748-9.
Collapse
Affiliation(s)
- Caifeng Li
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, NO.154, Anshan Road, Heping District, Tianjin, China
| | - Qian Ren
- Advertising Center, Tianjin Daily, Tianjin, China
| | - Xin Li
- Department of Cardiothoracic Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongqiu Han
- Department of General Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Min Peng
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, NO.154, Anshan Road, Heping District, Tianjin, China
| | - Keliang Xie
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, NO.154, Anshan Road, Heping District, Tianjin, China.
| | - Zhiqiang Wang
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, NO.154, Anshan Road, Heping District, Tianjin, China.
| | - Guolin Wang
- Department of Critical Care Medicine, Tianjin Medical University General Hospital, NO.154, Anshan Road, Heping District, Tianjin, China.
| |
Collapse
|
3
|
Bastia L, Viganò M, Scattolini C, Fossi F, Pozzi F, Curto F, Chieregato A. Electrical Impedance Tomography to Evaluate Sigh Effects in Unilateral Lung Injury. Am J Respir Crit Care Med 2022; 206:108-110. [PMID: 35666825 DOI: 10.1164/rccm.202112-2820im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Luca Bastia
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy;
| | - Martina Viganò
- University of Milan-Bicocca, 9305, Medicine, Milano, Italy
| | - Carla Scattolini
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy
| | - Francesca Fossi
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy
| | - Federico Pozzi
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy
| | - Francesco Curto
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy
| | - Arturo Chieregato
- ASST Grande Ospedale Metropolitano Niguarda, 9338, Neurointensive Care Unit, Milano, Italy
| |
Collapse
|
4
|
Berteotti C, Lo Martire V, Alvente S, Bastianini S, Matteoli G, Silvani A, Zoccoli G. Effect of ambient temperature on sleep breathing phenotype in mice: the role of orexins. J Exp Biol 2020; 223:jeb219485. [PMID: 32457059 DOI: 10.1242/jeb.219485] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/19/2020] [Indexed: 11/20/2022]
Abstract
The loss of orexinergic neurons, which release orexins, results in narcolepsy. Orexins participate in the regulation of many physiological functions, and their role as wake-promoting molecules has been widely described. Less is known about the involvement of orexins in body temperature and respiratory regulation. The aim of this study was to investigate if orexin peptides modulate respiratory regulation as a function of ambient temperature (Ta) during different sleep stages. Respiratory phenotype of male orexin knockout (KO-ORX, N=9) and wild-type (WT, N=8) mice was studied at thermoneutrality (Ta=30°C) or during mild cold exposure (Ta=20°C) inside a whole-body plethysmography chamber. The states of wakefulness (W), non-rapid eye movement sleep (NREMS) and rapid eye movement sleep (REMS) were scored non-invasively, using a previously validated technique. In both WT and KO-ORX mice, Ta strongly and significantly affected ventilatory period and minute ventilation values during NREMS and REMS; moreover, the occurrence rate of sleep apneas in NREMS was significantly reduced at Ta=20°C compared with Ta=30°C. Overall, there were no differences in respiratory regulation during sleep between WT and KO-ORX mice, except for sigh occurrence rate, which was significantly increased at Ta=20°C compared with Ta=30°C in WT mice, but not in KO-ORX mice. These results do not support a main role for orexin peptides in the temperature-dependent modulation of respiratory regulation during sleep. However, we showed that the occurrence rate of sleep apneas critically depends on Ta, without any significant effect of orexin peptides.
Collapse
Affiliation(s)
- Chiara Berteotti
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Viviana Lo Martire
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Sara Alvente
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Stefano Bastianini
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Gabriele Matteoli
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Alessandro Silvani
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| | - Giovanna Zoccoli
- PRISM Lab, Department of Biomedical and Neuromotor Sciences, and Center for Applied Biomedical Research, Department of Medical and Surgical Sciences, Sant'Orsola University Hospital, Alma Mater Studiorum - University of Bologna, Bologna 40126, Italy
| |
Collapse
|
5
|
Dhaibar H, Gautier NM, Chernyshev OY, Dominic P, Glasscock E. Cardiorespiratory profiling reveals primary breathing dysfunction in Kcna1-null mice: Implications for sudden unexpected death in epilepsy. Neurobiol Dis 2019; 127:502-511. [PMID: 30974168 PMCID: PMC6588471 DOI: 10.1016/j.nbd.2019.04.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/14/2019] [Accepted: 04/05/2019] [Indexed: 12/20/2022] Open
Abstract
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality, but the relative importance of underlying cardiac and respiratory mechanisms remains unclear. To illuminate the interactions between seizures, respiration, cardiac function, and sleep that contribute to SUDEP risk, here we developed a mouse epilepsy monitoring unit (EMU) to simultaneously record video, electroencephalography (EEG), electromyography (EMG), plethysmography, and electrocardiography (ECG) in a commonly used genetic model of SUDEP, the Kcna1 knockout (Kcna1-/-) mouse. During interictal periods, Kcna1-/- mice exhibited an abnormal absence of post-sigh apneas and a 3-fold increase in respiratory variability. During spontaneous convulsive seizures, Kcna1-/- mice displayed an array of aberrant breathing patterns that always preceded cardiac abnormalities. These findings support respiratory dysfunction as a primary risk factor for susceptibility to deleterious cardiorespiratory sequelae in epilepsy and reveal a new role for Kcna1-encoded Kv1.1 channels in the regulation of basal respiratory physiology.
Collapse
Affiliation(s)
- Hemangini Dhaibar
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center Shreveport, LA 71103, USA.
| | - Nicole M Gautier
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center Shreveport, LA 71103, USA.
| | - Oleg Y Chernyshev
- Department of Neurology, Division of Sleep Medicine, Louisiana State University Health Sciences Center Shreveport, LA 71103, USA.
| | - Paari Dominic
- Department of Internal Medicine, Section of Cardiology, Louisiana State University Health Sciences Center Shreveport, LA 71103, USA.
| | - Edward Glasscock
- Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center Shreveport, LA 71103, USA.
| |
Collapse
|
6
|
Mauri T, Foti G, Fornari C, Constantin JM, Guerin C, Pelosi P, Ranieri M, Conti S, Tubiolo D, Rondelli E, Lovisari F, Fossali T, Spadaro S, Grieco DL, Navalesi P, Calamai I, Becher T, Roca O, Wang YM, Knafelj R, Cortegiani A, Mancebo J, Brochard L, Pesenti A. Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: study protocol for a pilot randomized controlled trial, the PROTECTION trial. Trials 2018; 19:460. [PMID: 30157955 PMCID: PMC6114230 DOI: 10.1186/s13063-018-2828-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/28/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). METHODS PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and undergoing PSV from 4 to 24 h will be enrolled. All patients will first undergo a 30-min sigh test by adding sigh to clinical PSV for 30 min to identify early oxygenation responders. Then, patients will be randomized to PSV or PSV + sigh until extubation, ICU discharge, death or day 28. Sigh will be delivered as a 3-s pressure control breath delivered once per minute at 30 cmH2O. Standardized protocols will guide ventilation settings, switch back to controlled ventilation, use of rescue treatments, performance of spontaneous breathing trial, extubation and reintubation. The primary endpoint of the study will be to verify the feasibility of PSV + sigh evaluated through reduction of failure to remain on assisted ventilation during the first 28 days in the PSV + sigh group versus standard PSV (15 vs. 22%). Failure will be defined by switch back to controlled ventilation for more than 24 h or use of rescue treatments or reintubation within 48 h from elective extubation. Setting the power to 80% and first-risk order to 5%, the computed size of the trial is 129 patients per arm. DISCUSSION PROTECTION is a pilot randomized controlled trial testing the feasibility of adding sigh to PSV. If positive, it will provide physicians with an effective addition to standard PSV for lung protection, able to reduce failure of assisted ventilation. PROTECTION will provide the basis for a future larger trial aimed at verifying the impact of PSV + sigh on 28-day survival and ventilator-free days. TRIAL REGISTRATION ClinicalTrials.gov, NCT03201263 . Registered on 28 June 2017.
Collapse
Affiliation(s)
- Tommaso Mauri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giuseppe Foti
- ASST Monza, University of Milan-Bicocca, Monza, Italy
| | - Carla Fornari
- Research Centre on Public Health, School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Jean-Michel Constantin
- Department of Preoperative Medicine, University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | - Claude Guerin
- Service de Réanimation Médicale, Hôpital de la Croix Rousse, Lyon, France
| | - Paolo Pelosi
- Department of Surgical and Integrated Diagnostics, San Martino Policlinico Hospital, IRCCS for Oncology, University of Genoa, Genoa, Italy
| | - Marco Ranieri
- Department of Anesthesia and Intensive Care Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Sara Conti
- Research Centre on Public Health, School of Medicine and Surgery, University of Milan-Bicocca, Monza, Italy
| | - Daniela Tubiolo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Egle Rondelli
- ASST Monza, University of Milan-Bicocca, Monza, Italy
| | - Federica Lovisari
- Department of Anesthesia and Critical Care, Niguarda Hospital, University of Milan-Bicocca, Milan, Italy
| | - Tommaso Fossali
- Department of Anesthesiology and Intensive Care, ASST Fatebenefratelli Sacco - Luigi Sacco Hospital, Milan, Italy
| | - Savino Spadaro
- Department of morphology, surgery and experimental medicine, Azienda Ospedaliera-Universitaria Arcispedale Sant'Anna, Ferrara, Italy
| | - Domenico Luca Grieco
- Department of Anesthesiology and Intensive Care Medicine, Catholic University of The Sacred Heart, IRCCS Fondazione Policlinico A. Gemelli, Rome, Italy
| | - Paolo Navalesi
- Dipartimento di Scienze Mediche e Chirurgiche, Università Magna Graecia di Catanzaro, Azienda Ospedaliera Universitaria Mater Domini, Catanzaro, Italy
| | - Italo Calamai
- AUSL Toscana Centro, Unit of Anesthesia and Resuscitation, San Giuseppe Hospital, Empoli, Italy
| | - Tobias Becher
- Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Oriol Roca
- Critical Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Yu-Mei Wang
- Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Rihard Knafelj
- Center for Internal Intensive medicine (MICU), University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Andrea Cortegiani
- Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico Paolo Giaccone, University of Palermo, Palermo, Italy
| | - Jordi Mancebo
- Servei de Medicina Intensiva, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Laurent Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.,Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Antonio Pesenti
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. .,Anesthesia and Critical Care, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. .,Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy.
| | | |
Collapse
|
7
|
Sheikhbahaei S, Gourine AV, Smith JC. Respiratory rhythm irregularity after carotid body denervation in rats. Respir Physiol Neurobiol 2017; 246:92-97. [PMID: 28782663 PMCID: PMC5637156 DOI: 10.1016/j.resp.2017.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/09/2017] [Accepted: 08/01/2017] [Indexed: 12/13/2022]
Abstract
Respiratory activity is controlled by inputs from the peripheral and central chemoreceptors. Since overactivity of the carotid bodies, the main peripheral chemoreceptors, is linked to the pathophysiology of disparate metabolic and cardiovascular diseases, carotid body denervation (CBD) has been proposed as a potential treatment. However, long-term effects of CBD on the respiratory rhythm and regularity of breathing remain unknown. Here, we show that five weeks after bilateral CBD in rats, the respiratory rhythm was slower and less regular. Ten weeks after bilateral CBD, the respiratory frequency was not different from the sham-operated group, but the regularity of the respiratory rhythm was still reduced. Increased frequency of randomly occurring apneas is likely to be responsible for the irregular breathing pattern after CBD. These results should be taken into consideration since any treatment that reduces the stability of the respiratory rhythm might exacerbate the cardio-respiratory instability and worsen the cardiovascular outcomes.
Collapse
Affiliation(s)
- Shahriar Sheikhbahaei
- Cellular and Systems Neurobiology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA; Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology, and Pharmacology, University College London, London WC1E 6BT, UK.
| | - Alexander V Gourine
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology, and Pharmacology, University College London, London WC1E 6BT, UK
| | - Jeffrey C Smith
- Cellular and Systems Neurobiology Section, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA
| |
Collapse
|
8
|
Vaschillo EG, Vaschillo B, Buckman JF, Nguyen-Louie T, Heiss S, Pandina RJ, Bates ME. The effects of sighing on the cardiovascular system. Biol Psychol 2015; 106:86-95. [PMID: 25720947 PMCID: PMC4386588 DOI: 10.1016/j.biopsycho.2015.02.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 02/11/2015] [Accepted: 02/14/2015] [Indexed: 11/23/2022]
Abstract
Elicitation of high-amplitude oscillations in the cardiovascular system may serve to dampen psychophysiological reactivity to emotional and cognitive loading. Prior work has used paced breathing to impose clinically valuable high-amplitude ∼ 0.1 Hz oscillations. In this study, we investigated whether rhythmical sighing could likewise produce high-amplitude cardiovascular oscillations in the very low frequency range (0.003-0.05 Hz). ECG, respiration, skin conductance, and beat-to-beat blood pressure were collected in 24 healthy participants during baseline, 0.1 Hz paced breathing, and 0.02 Hz paced sighing (1 sigh every 50s, with normal breathing interspersed). Results showed that each sigh elicited a strong, well-defined reaction in the cardiovascular system. This reaction did not habituate when participants repeatedly sighed for 8.5 min. The result was a high-amplitude 0.02 Hz oscillation in multiple cardiovascular parameters. Thus, paced sighing is a reliable method for imposing very low frequency oscillations in the cardiovascular system, which has research and clinical implications that warrant further study.
Collapse
Affiliation(s)
- Evgeny G Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Bronya Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Jennifer F Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Tam Nguyen-Louie
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
| | - Sydney Heiss
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Robert J Pandina
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| |
Collapse
|
9
|
Garcia AJ 3rd, Koschnitzky JE, Ramirez JM. The physiological determinants of sudden infant death syndrome. Respir Physiol Neurobiol 2013; 189:288-300. [PMID: 23735486 DOI: 10.1016/j.resp.2013.05.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 05/19/2013] [Accepted: 05/27/2013] [Indexed: 01/08/2023]
Abstract
It is well-established that environmental and biological risk factors contribute to Sudden Infant Death Syndrome (SIDS). There is also growing consensus that SIDS requires the intersection of multiple risk factors that result in the failure of an infant to overcome cardio-respiratory challenges. Thus, the critical next steps in understanding SIDS are to unravel the physiological determinants that actually cause the sudden death, to synthesize how these determinants are affected by the known risk factors, and to develop novel ideas for SIDS prevention. In this review, we will examine current and emerging perspectives related to cardio-respiratory dysfunctions in SIDS. Specifically, we will review: (1) the role of the preBötzinger complex (preBötC) as a multi-functional network that is critically involved in the failure to adequately respond to hypoxic and hypercapnic challenges; (2) the potential involvement of the preBötC in the gender and age distributions that are characteristic for SIDS; (3) the link between SIDS and prematurity; and (4) the potential relationship between SIDS, auditory function, and central chemosensitivity. Each section underscores the importance of marrying the epidemiological and pathological data to experimental data in order to understand the physiological determinants of this syndrome. We hope that a better understanding will lead to novel ways to reduce the risk to succumb to SIDS.
Collapse
|