The failing ventilatory pump
LungPublished 1 December 1982Open access
C. Roussos
Citations61
SJR quartileQ1
SJR score1.01
SNIP1.10
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
This review will focus on situations resulting from a compromised ventilatory pump due to low driving force (weakness) of the respiratory system.
Abstract
Originally (Homer) meaning breastplate, curiass, corslet and eventually armour.With Hippocrates, "thorax" signified the area covered by the breast plate, or the entire trunk.In Plato's time, the 'thorax' delimited the walls of the cavity extending from the neck to the genitalia, and was separated by the midrift.Progressively, the region encompassed by the thorax has been reduced to the breast, or the chest.
Keywords
MedicineNeuroscienceEngineering
The Journal of PhysiologyVoluntary strength and fatigue
1,419 Citations1954P A Merton
The paper shows that a maximal voluntary effort develops the same tension as a maximal tetanus artificially excited; in the second part the same equality is found to persist during fatigue, implying that in fatigue, too, the limitation of strength is peripheral.
American Journal of Physiology-Legacy ContentHemodynamic Determinants of Oxygen Consumption of the Heart With Special Reference to the Tension-Time Index
1,317 Citations1957Stanley J. Sarnoff, Eugene Braunwald +4 more
The hemodynamic determinants of myocardial oxygen utilization were ascertained in the isolated, metabolically supported, nonfailing canine heart and the primary determinant was found to be the total oxygen requirement.
The Journal of PhysiologyEffects of pH on the myofilaments and the sarcoplasmic reticulum of skinned cells from cardiace and skeletal muscles.
1,090 Citations1978A Fabiato, F Fabiato
It was concluded that the effects of acidosis on the cardiac sarcoplasmic reticulum accentuate the depressive action of decreasing pH on the myofilaments, which may explain the pronounced depression of contractility observed during acidosis in cardiac muscle.
The American Journal of CardiologyControl of myocardial oxygen consumption
796 Citations1971Eugene Braunwald
A technique for reducing myocardial oxygen requirements by stimulating the carotid sinus nerves is described and its application to the treatment of angina pectoris demonstrated.
ScienceMammalian Motor Units: Physiological-Histochemical Correlation in Three Types in Cat Gastrocnemius
785 Citations1971Robert E. Burke, David N. Levine +3 more
The correlation among a variety of physiological properties and the histochemical characteristics of muscle fibers belonging to single motor units in a mixed mammalian muscle is directly demonstrated.
Acta Physiologica ScandinavicaMuscle Glycogen during Prolonged Severe Exercise
747 Citations1967L. Hermansen, E. Hultman +1 more
A close relationship between utilized glycogen and combusted carbohydrate was found, and it seems highly probable that at high relative workloads primarily the glycogen stores in the exercising muscles will limit the capacity for prolonged strenuous work.
Journal of Applied PhysiologyVentilatory muscle strength and endurance training
597 Citations1976David Leith, M. E. Bradley
It is concluded that ventilatory muscle strength or endurance can be specifically increased by appropriate ventilatories muscle training programs.
Pflügers Archiv - European Journal of PhysiologyThe time course of phosphorylcreatine resynthesis during recovery of the quadriceps muscle in man
523 Citations1976Roger C. Harris, R. H. T. Edwards +4 more
Occlusion of the circulation to the quadriceps completely abolished the resynthesis of PC and Restoration of resynthesis occurred only after release of occlusion.
Journal of Applied PhysiologyDiaphragmatic fatigue in man
496 Citations1977C Roussos, Peter T. Macklem
Insofar as the behavior of the diaphragm reflects that of other respiratory muscles it appears that quite high inspiratory loads can be tolerated indefinitely, but when the energy consumption of the respiratory muscles exceeds a critical level, fatigue should develop.
NatureMuscular fatigue investigated by phosphorus nuclear magnetic resonance
453 Citations1978M. Joan Dawson, David G. Gadian +1 more
Muscular fatigue has been studied using 31P NMR to measure the levels and rates of utilisation of several key metabolites and the free-energy change for ATP hydrolysis.
New England Journal of MedicineAcute Respiratory Failure in the Adult
423 Citations1972Henning Pontoppidan, Bennie Geffin +1 more
Clinical ScienceCentral and Peripheral Fatigue in Sustained Maximum Voluntary Contractions of Human Quadriceps Muscle
415 Citations1978B. Bigland-Ritchie, David A. Jones +2 more
It is concluded that in sustained maximum voluntary contractions of the quadriceps central fatigue may account for an appreciable proportion of the force loss, and surface EMG recordings provide no evidence that neuromuscular junction failure is the limiting factor determining the loss of force in this muscle.
Annals of Internal MedicineMechanisms of Contraction of the Normal and Failing Heart.
367 Citations1976E. Braunwald, John Ross +1 more
Journal of Applied PhysiologyRespiratory muscle fatigue during cardiogenic shock
346 Citations1981Michel Aubier, Teresa Trippenbach +1 more
It is concluded that the ventilatory failure of cardiogenic shock is due to an impairment of the contractile process of the respiratory muscles, which avoids respiratory failure and prolongs survival, which may bear important therapeutic implications.
The Journal of PhysiologyThe blood flow through muscle during sustained contraction
331 Citations1939H. Barcroft, Jim Millen
A further proof of the ischaemic nature of human muscle during strong contraction is given and the method shares this disadvantage, but has the advantage that it gives qualitative results concerning the blood flow through a single group of human muscles.
The Journal of PhysiologyFatigue of maintained voluntary muscle contraction in man
318 Citations1972John A. Stephens, Anthony R. Taylor
The mechanism of fatigue has been studied in maintained maximal voluntary contractions of the first dorsal interosseous muscle of the hand and the results show that these contractions are associated with fatigue in mice.
The Journal of PhysiologyContraction and recovery of living muscles studied by <sup>31</sup>p nuclear magnetic resonance
295 Citations1977David G. Gadian, M. Joan Dawson +1 more
Methods for maintaining muscles in physiological condition, stimulating them and recording tension while at the same time accumulating their 31P NMR spectra are developed.
Quarterly Reviews of BiophysicsKinetic Analysis of ATPase Mechanisms
289 Citations1976David R. Trentham, John F. Eccleston +1 more
Journal of Applied PhysiologyElectromyogram pattern of diaphragmatic fatigue
288 Citations1979D Gross, A. Grassino +2 more
It was concluded that frequency spectrum analysis of the EMG can detect diaphragmatic fatigue reliably, prior to the time when thediaphragm fails as a pressure generator.
The Journal of PhysiologyThe blood flow through active and inactive muscles of the forearm during sustained hand‐grip contractions
286 Citations1963P. W. Humphreys, A. R. Lind
PubMedFunctional adaptations to physical activity and inactivity.
279 Citations1980Bengt Saltin, L. B. Rowell
The increase in the oxidative potential of skeletal muscle after training is presented as the mechanism by which capacity for submaximal work is augmented.
Journal of Applied PhysiologyFatigue of inspiratory muscles and their synergic behavior
258 Citations1979C Roussos, Mark Fixley +2 more
Monitoring the abdominal pressure revealed that the contribution of the diaphragm and intercostal accessory muscles alternated in time, possibly postponing the onset of fatigue.
Journal of Applied PhysiologyLactate, ATP, and CP in working muscles during exhaustive exercise in man
253 Citations1970J. Karlsson, Bengt Saltin
The dynamics of lactate accumulation in working muscle was studied in three subjects performing maximal bicycle exercise of 2, 6, and 16 min duration.
The Journal of PhysiologyThree factors limiting the reliable detection of light by retinal ganglion cells of the cat
251 Citations1969H. B. Barlow, W. R. Levick
Responses of cat retinal ganglion cells have been examined with a view to specifying the characteristics that limit the detection of light stimuli.
Journal of Applied PhysiologyDetection of diaphragmatic fatigue in man by phrenic stimulation
209 Citations1981Michel Aubier, Gary J. Farkas +3 more
It is suggested that this long-lasting element of fatigue might occur in patients with chronic obstructive lung disease, predisposing them to respiratory failure and that diaphragmatic strength after fatigue recovers faster at high than at low frequencies of stimulation.
The American Journal of MedicineThe effect of training on strength and endurance of the diaphragm in quadriplegia
198 Citations1980D. R. Gross, H Ladd +3 more
It was concluded that quadriplegics are predisposed to the development of inspiratory muscle fatigue due to reduced muscle strength and reduction in endurance, and in these patientsInspatory muscle training increases both strength and Endurance, and protects against fatigue.
Journal of Clinical InvestigationTHE RELATIONSHIP OF OXYGEN COST OF BREATHING TO RESPIRATORY MECHANICAL WORK AND RESPIRATORY FORCE
192 Citations1961Maurice McGregor, Margaret R. Becklake
The objective of this study was to ascertain whether the relationship of oxygen cost to mechanical respiratory work is the same for hyperventilation as for resistance breathing in normal subjects and to test whether the same relationships hold in the presence of diseases which alter the mechanical properties of the lung.
American Review of Respiratory DiseaseThe Role of Respiratory Muscles in the Hyperinflation of Bronchial Asthma
189 Citations1980James G. Martin, Elizabeth E. Powell +3 more
It is concluded that the increase in FRC in induced asthma is substantially influenced by persistent inspiratory intercostal and accessory muscle activity during expiration, which results in a chest wall configuration that tends to optimize diaphragmatic function.
Journal of Clinical InvestigationThe relationship of respiratory failure to the oxygen consumption of, lactate production by, and distribution of blood flow among respiratory muscles during increasing inspiratory resistance.
187 Citations1977Charles H. Robertson, Greg Foster +1 more
An animal model was developed to determine if blood flow to the respiratory muscles limits oxygen delivery and thus work output during inspiratory resistance; blood flow and oxygen consumption were even higher than that observed during previous resistances and there was no evidence of a shift to anaerobic metabolsim in blood lactate and pyruvate levels.
Clinical SciencePhysiological Analysis of Skeletal Muscle Weakness and Fatigue
157 Citations1978R. H. T. Edwards
American Journal of Physiology-Legacy ContentLactate and contractile force in frog muscle during development of fatigue and recovery
151 Citations1976R. H. Fitts, J. O. Holloszy
Recovery of contractile force lagged behind the decrease in lactate; a given concentration of muscle lactate was associated with a higher contractiles force early during development of fatigue than late during recovery.
Acta Physiologica ScandinavicaGlycogen Depletion Pattern in Human Muscle Fibres During Distance Running
151 Citations1973D. L. Costill, P. D. Gollnick +3 more
The results suggest a primary reliance upon slow twitch fibres during prolonged running and point to the limitations of assessing substrate utilization or availability in working fibres from muscle samples with mixed fibre populations.
Journal of Applied PhysiologySpectral analysis of human inspiratory diaphragmatic electromyograms
149 Citations1979T. W. Schweitzer, James W. Fitzgerald +2 more
New England Journal of MedicineAcute Respiratory Failure in the Adult
144 Citations1972Henning Pontoppidan, Bennie Geffin +1 more
Clinical ScienceFunctional and Structural Changes after Disuse of Human Muscle
140 Citations1977A. J. Sargeant, C. T. M. Davies +3 more
The discrepancy between the magnitude of the difference observed in the gross measurement of leg function (maximum oxygen uptake) and structure (leg volume) as compared with the cellular level (cross-sectional fibre area) is discussed.
PubMedThe failing inspiratory muscles under normoxic and hypoxic conditions.
133 Citations1981Joyce Santos Jardim, Gary J. Farkas +4 more
It was concluded that respiratory muscles, working against high inspiratory resistances, fall as pressure generators sooner during low oxygen breathing, resulting in a shorter endurance time, a faster rate in the shift of the electromyographic power spectrum, and a greater rate of increase in blood lactate concentrations.
The Journal of PhysiologyHeat production and chemical changes during isometric contractions of the human quadriceps muscle.
129 Citations1975R. H. T. Edwards, D. K. Hill +1 more
It is suggested that the slowing of relaxation and the increased economy of force maintenance may both be due to an increased cross‐bridge cycle time in the fatigued muscle.
Journal of Applied PhysiologyPartitioning of inspiratory pressure swings between diaphragm and intercostal/accessory muscles
128 Citations1978Peter T. Macklem, D Gross +2 more
The analysis indicates that the diaphragm can act both as a fixator, preventing transmission of Ppl to the abdomen and as an agonist, when abdominal muscles remain relaxed it only assumes the latter role to the extent that Pab increases.
PubMedThoracoabdominal motion in chronic obstructive pulmonary disease.
114 Citations1977John T. Sharp, Norma Boone Goldberg +3 more
A significant proportion of patients with disabling chronic obstructive pulmonary disease show abnormalities in thoracoabdominal motion that are observable with the respiratory magnetometer and ofter by simple inspection, most of these abnormalities suggest malfunction of respiratory muscles, particularly the diaphragm.
CHEST JournalAsynchronous Breathing Movements in Patients with Chronic Obstructive Pulmonary Disease
114 Citations1975Kumar Ashutosh, Robert Gilbert +2 more
Compared to COPD patients with a normal breathing pattern, those with asynchronous breathing movements had poorer ventilatory mechanics and 10 of the 13 were dependent on assisted ventilation.
Journal of Clinical InvestigationDiaphragmatic blood flow and energy expenditure in the dog. Effects of inspiratory airflow resistance and hypercapnia.
113 Citations1976Dudley F. Rochester, Giuliano Bettini
It is concluded that augmentation of perfusion permits the diaphragm to sustain high levels of contractile effort when the work of breathing is increased.
Journal of Applied PhysiologyCellular adaptations of the ventilatory muscles to a chronic increased respiratory load
111 Citations1978Thomas G. Keens, V. Chen +4 more
It is concluded that cellular adaptations are induced in the ventilatory muscles by chronic increased respiratory loads.
Respiration PhysiologySustained maximum voluntary ventilation
103 Citations1970S. Freedman
The ability of normal subjects to sustain maximum voluntary ventilation for 4 min has been investigated using a method in which the subject was asked to follow a target level of ventilation and in which hypocapnia was avoided by the use of partial rebreathing.
American Journal of Physiology-Legacy ContentSource of fat oxidation in exercising dogs
99 Citations1964B. Issekutz, H. I. Miller +2 more
Dogs with indwelling arterial and venous catheters ran on a treadmill for 30–40 min and palmitate-1-C14 was infused intravenously to increase the rate of FFA uptake.
Journal of Applied PhysiologyTonic inspiratory muscle activity as a cause of hyperinflation in histamine-induced asthma
85 Citations1980N. L. Muller, A. C. Bryan +1 more
It is concluded that histamine-induced hyperinflation is accompanied by persistent inspiratory muscle activity throughout expiration, which is associated with a significant increase in tonic activity of the intercostal muscles and the diaphragm.
Respiration PhysiologyThe ability to sustain great breathing efforts
76 Citations1968S.M. Tenney, R.E. Reese
Proceedings of the Royal Society of London Series B Containing Papers of a Biological CharacterAnaerobic and aerobic activity in isolated muscle
60 Citations1929Archibald Vivian Hill, P. S. Kupalov
It is found that by suspending a sufficiently thin muscle in oxygen-free Ringer's solution and exciting it sufficiently slowly, to allow diffusion to remove the lactic acid as it is formed, the muscle is found to liberate 2 to 3 times as much energy as it would it diffusion were not permitted.
Advances in experimental medicine and biologyEnergy Rich Phosphagens in Dynamic and Static Work
57 Citations1971Jonas Bergström, Roger C. Harris +2 more
In the present studies muscle samples have been obtained using the needle biopsy technique and the levels of a number of metabolites in these have been determined by enzymatic micro-methods.
Proceedings of the Royal Society of London. Series B, Biological sciencesFatigue and neuromuscular block in mammalian skeletal muscle
50 Citations1949G. L. Brown, B. Delisle Burns
Assessment of the neuromuscular block as fatigue progresses was made from observation of the tension changes which followed a sudden switch from direct to indirect excitation or vice versa.
Experimental Biology and MedicineNeuromuscular Blocking Properties of Various Polypeptide Antibiotics.
39 Citations1960S. Lee Adamson, F. N. Marshall +1 more
The amino acids and other constituents comprising the various peptide antibiotics failed to show neuromuscular blocking activity and the relative potencies of the antibiotics in relation to colistin sulfate were determined.
Journal of Applied PhysiologyFraction of maximum breathing capacity available for prolonged hyperventilation
37 Citations1960G. P. Zocche, Harry W. Fritts +1 more
Data suggest that the MBC is not the limiting response to be expected from stimuli such as hypoxia or hypercapnia, and that the capacity of a patient for maintaining an augmented minute volume is an important determinant of the responses these stimuli evoke.
New England Journal of MedicineMechanisms of Contraction of the Normal and Failing Heart
32 Citations1967Eugene Braunwald, John Ross +1 more
The LancetWEAKNESS IN MYOTONIC SYNDROMES
18 Citations1977C. M. Wiles, R. H. T. Edwards
In individual myotonic disorders the ability to identify the origin of the muscle weakness and the functional level at which the defect occurs would assist the choice of rational treatment.
British Journal of PharmacologyA COMPARISON OF THE EFFECTS OF SODIUM THIOCYANATE AND DANTROLENE SODIUM ON A MAMMALIAN ISOLATED SKELETAL MUSCLE
15 Citations1977R. F. W. Moulds
It is concluded that the mechanism of action of dantrolene is by inhibition of the release of the calcium ions involved in the ECC mechanism, probably at the level of the transverse tubules.
JAMARespiratory failure in neuromuscular disease. Management in a respiratory intensive care unit
11 Citations1976Walter J. O’Donohue
