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Effects of Altered Intra-abdominal Pressure on the Upper Airway Collapsibility in a Porcine Model

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收录情况: ◇ SCIE ◇ 统计源期刊 ◇ CSCD-C ◇ 中华系列

机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Gen Surg, Beijing 100730, Peoples R China [2]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing 100730, Peoples R China [3]Tsinghua Univ, Beijing Tsinghua Changgung Hosp, Dept Otolaryngol Head & Neck Surg, Beijing 102218, Peoples R China [4]Univ British Columbia, Dept Med, Div Resp, Vancouver, BC, Canada
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关键词: Abdominal Obesity Intra-abdominal Pressure Lung Volume Obstructive Sleep Apnea Trachea Traction

摘要:
Background: Obstructive sleep apnea is strongly associated with obesity, particularly abdominal obesity common in centrally obese males. Previous studies have demonstrated that intra-abdominal pressure (IAP) is increased in morbid obesity, and tracheal traction forces may influence pharyngeal airway collapsibility. This study aimed to investigate that whether IAP plays a role in the mechanism of upper airway (UA) collapsibility via IAP-related caudal tracheal traction. Methods: An abdominal wall lifting (AWL) system and graded CO 2 pneumoperitoneum pressure was applied to four supine, anesthetized Guizhou miniature pigs and its effects on tracheal displacement (TD) and airflow dynamics of UA were studied. Individual run data in 3 min obtained before and after AWL and obtained before and after graded pneumoperitoneum pressure were analyzed. Differences between baseline and AWL/graded pneumoperitoneum pressure data of each pig were examined using a Student's t-test or analysis of variance. Results: Application of AWL resulted in decreased IAP and significant caudal TD. The average displacement amplitude was 0.44 mm (P < 0.001). There were three subjects showed increased tidal volume (TV) (P < 0.01) and peak inspiratory airflow (P < 0.01); however, the change of flow limitation inspiratory UA resistance (Rua) was not significant. Experimental increased IAP by pneumoperitoneum resulted in significant cranial TD. The average displacement amplitude was 1.07 mm (P < 0.001) when IAP was 25 cmH(2)O compared to baseline. There were three subjects showed reduced Rua while the TV increased (P < 0.01). There was one subject had decreased TV and elevated Rua (P < 0.001). Conclusions: Decreased IAP significantly increased caudal TD, and elevated IAP significantly increased cranial TD. However, the mechanism of UA collapsibility appears primarily mediated by changes in lung volume rather than tracheal traction effect. TV plays an independent role in the mechanism of UA collapsibility.

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出版当年[2014]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 医学:内科
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出版当年[2013]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q1 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2013版] 出版当年五年平均 出版前一年[2012版] 出版后一年[2014版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Gen Surg, Beijing 100730, Peoples R China
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通讯机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Gen Surg, Beijing 100730, Peoples R China [*1]Department of General Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
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