Temporal relationships of ventilatory failure, pump failure, and diaphragm fatigue

C. S H Sassoon, Steve E. Gruer, Gary C Sieck

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The time course of ventilatory failure, pump failure, and diaphragm peripheral fatigue was determined during the application of external inspiratory resistive loads (IRL) in anesthetized rabbits. Pump failure is defined as the inability of the diaphragm to sustain the expected force under IRL. To assess contractile fatigue, transdiaphragmatic pressures (Pdi) generated by bilateral phrenic nerve stimulation at 75 Hz (Pdi-75) and 20 Hz (Pdi-20) were measured. The amplitude of evoked diaphragm electromyographic (EMG) signals was measured to assess neurotransmission failure. The rate of rise of spontaneous diaphragm EMG was used as an index of respiratory drive. Ventilation was evaluated together with arterial blood gases. During IRL the rate of rise of spontaneous diaphragm EMG increased, and there was a progressive hypercapnic acidosis and hypoxemia, indicating ventilatory failure. In contrast, Pdi-75 and Pdi-20 were stable until the time of respiratory arrest (apnea), when they decreased by 34 and 45%, respectively. The amplitude of evoked diaphragm EMG signals remained unchanged throughout the IRL and decreased only slightly at the time of apnea. We conclude that IRL induces progressive ventilatory failure long before any contractile fatigue of the diaphragm or pump failure occurs. This suggests that ventilatory failure is due to central fatigue, whereas pump failure (apnea) is attributable to multiple factors.

Original languageEnglish (US)
Pages (from-to)238-245
Number of pages8
JournalJournal of Applied Physiology
Volume81
Issue number1
StatePublished - Jul 1996
Externally publishedYes

Fingerprint

Diaphragm
Fatigue
Apnea
Phrenic Nerve
Acidosis
Synaptic Transmission
Ventilation
Gases
Rabbits
Pressure

Keywords

  • apnea
  • central fatigue
  • neuromuscular transmission failure
  • peripheral diaphragm fatigue
  • resistive load

ASJC Scopus subject areas

  • Endocrinology
  • Physiology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Sassoon, C. S. H., Gruer, S. E., & Sieck, G. C. (1996). Temporal relationships of ventilatory failure, pump failure, and diaphragm fatigue. Journal of Applied Physiology, 81(1), 238-245.

Temporal relationships of ventilatory failure, pump failure, and diaphragm fatigue. / Sassoon, C. S H; Gruer, Steve E.; Sieck, Gary C.

In: Journal of Applied Physiology, Vol. 81, No. 1, 07.1996, p. 238-245.

Research output: Contribution to journalArticle

Sassoon, CSH, Gruer, SE & Sieck, GC 1996, 'Temporal relationships of ventilatory failure, pump failure, and diaphragm fatigue', Journal of Applied Physiology, vol. 81, no. 1, pp. 238-245.
Sassoon, C. S H ; Gruer, Steve E. ; Sieck, Gary C. / Temporal relationships of ventilatory failure, pump failure, and diaphragm fatigue. In: Journal of Applied Physiology. 1996 ; Vol. 81, No. 1. pp. 238-245.
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