title: Action of the inspiratory muscles of the rib cage during breathing in newborns.
abstract: To determine whether the rib cage muscles actively contribute to tidal volume change in infancy, we measured tidal volume (VT), using a pneumotachograph, respiratory gastric pressure swings (Pga), using a liquid-filled gastric catheter, and rib cage and abdominal volume, using respiratory inductive plethysmography in 15 newborns, both before and during 2% CO2-induced hyperventilation. Active rib cage expansion produced by phasic contraction of the inspiratory muscles of the rib cage should reduce respiratory abdominal pressure fluctuations by moving the anterior abdominal wall outward and cephalad, thereby having an expanding influence on the abdominal cavity. During quiet sleep (n = 13), CO2-induced hyperventilation was associated with significant increases in VT, Pga, rib cage volume (Vrc), and abdominal volume (Vab). Increments in Pga were small relative to VT, as shown by an increase in the slope of the VT versus Pga respiratory loop (VT/Pga) in all subjects (p less than 0.001, paired t test). CO2 breathing was associated with an increase in the contribution of the rib cage compartment to total volume change (Vrc/Vrc + Vab) in all infants studied (p less than 0.001, paired t test), and the total volume response to hyperventilation was more strongly related to changes in rib cage volume (slope = 0.62, r = 0.90) than to abdominal volume (slope = 0.31, r = 0.60). During REM sleep (n = 6), mean VT/Pga did not change significantly, and the rib cage contribution to tidal breathing decreased in three of six infants.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anesthesia, Harvard Medical School, Boston, Massachusetts.
authors.forename: M B
authors.initials: MB
authors.lastname: Hershenson
authors.forename: A R
authors.initials: AR
authors.lastname: Stark
authors.forename: J
authors.initials: J
authors.lastname: Mead
mesh_terms: D000005:Abdomen / Q000502:physiology; D006801:Humans; D006985:Hyperventilation / Q000503:physiopathology; D007231:Infant, Newborn / Q000502:physiology*; D011312:Pressure; D012016:Reference Values; D012119:Respiration; D012132:Respiratory Muscles / Q000502:physiology*; D013909:Thorax / Q000502:physiology; D013990:Tidal Volume