Radiotelemetry system for apnea study in lambs.

Neonatal apneas are being studied in the laboratory using polysomnographic recordings in lambs. Standard equipment, requiring animal restraint, disrupts sleep and prevents development of spontaneous apneas. The aim of the current work was to develop and validate a wireless recording equipment to study freely moving lambs. Firstly, a radiotelemetry equipment composed of a multichannel FM transmitter and a receiver was developed. Secondly, to test the telemetry equipment, each biopotential - [electroencephalogram (EEG), electrooculogram (EOG), electrocardiogram (ECG), electromyograms (EMGs), nasal airflow] - was recorded simultaneously by standard equipment and by telemetry (5 lambs). The results indicated an excellent concordance between signals obtained by both systems. Finally, the 8-channel telemetry prototype was tested for polysomnographic recordings (16 lambs). Results obtained confirmed the possibility of recording frequent REM sleep periods and spontaneous apneas. In conclusion, this radiotelemetry polysomnographic equipment brings new possibilities for research on neonatal apneas.

Vagal afferents and active upper airway closure during pulmonary edema in lambs.

The present study was undertaken to gain further insight into the mechanisms responsible for the sustained active expiratory upper airway closure previously observed during high-permeability pulmonary edema in lambs. The experiments were conducted in nonsedated lambs, in which airflow and thyroarytenoid and inferior pharyngeal constrictor muscle electromyographic activity were recorded. We first studied the consequences of hemodynamic pulmonary edema (induced by impeding pulmonary venous return) on upper airway dynamics in five lambs; under this condition, a sustained expiratory upper airway closure consistently appeared. We then tested whether expiratory upper airway closure was related to vagal afferent activity from bronchopulmonary receptors. Five bivagotomized lambs underwent high-permeability pulmonary edema: no sustained expiratory upper airway closure was observed. Finally, we studied whether a sustained decrease in lung volume induced a sustained expiratory upper airway closure. Five lambs underwent a 250-ml pleural infusion: no sustained expiratory upper airway closure was observed. We conclude that 1) the sustained expiratory upper airway closure observed during pulmonary edema in nonsedated lambs is related to stimulation of vagal afferents by an increase in lung water and 2) a decrease in lung volume does not seem to be the causal factor.

Effects of capsaicin pretreatment on expiratory laryngeal closure during pulmonary edema in lambs.

The present study, performed in nonsedated, conscious lambs, consisted of two parts. In the first part, we 1) examined for the first time whether a respiratory response to pulmonary C-fiber stimulation could be elicited in nonsedated newborns and 2) determined whether this response could be abolished by capsaicin pretreatment. Then, by using capsaicin-desensitized lambs, we studied whether pulmonary C fibers were involved in the sustained, active expiratory upper airway closure previously observed during pulmonary edema. Airflow and thyroarytenoid and inferior pharyngeal constrictor muscle electromyographic activities were recorded. In the first set of experiments, a 5-10 microg/kg capsaicin bolus intravenous injection in seven intact lambs consistently led to a typical pulmonary chemoreflex, showing that C fibers are functionally mature in newborn lambs. In the second series of experiments, eight lambs pretreated with 25-50 mg/kg subcutaneous capsaicin did not exhibit any respiratory response to 10-50 microg/kg intravenous capsaicin injection, implicating C fibers in the response. Finally, in the above capsaicin-desensitized lambs, we observed that halothane-induced high-permeability pulmonary edema did not cause the typical response of sustained expiratory upper airway closure seen in the intact lamb. We conclude that functionally mature C fibers are present and responsible for a pulmonary chemoreflex in response to capsaicin intravenous injection in nonsedated lambs. Capsaicin pretreatment abolishes this reflex. Furthermore, the sustained expiratory upper airway closure observed during halothane-induced pulmonary edema in intact nonsedated lambs appears to be related to a reflex involving stimulation of pulmonary C fibers.

Coordination between glottic adductor muscle and diaphragm EMG activity in fetal lambs in utero.

It has previously been reported that active glottic adduction is present during prolonged apneas but absent during periods of breathing movements in fetal lambs in utero. The present study was aimed at examining the precise coordination between fetal breathing movements [diaphragm electromyographic (EMG) activity (Di EMG)] and glottic adduction [thyroarytenoid muscle EMG activity (TA EMG)]. Electrodes for electroencephalogram, eye movements, TA EMG, and Di EMG and an arterial catheter were surgically implanted in fetal lambs 123-142 days postconception. Polygraphic recordings were performed without sedation while the ewe breathed room air (n = 11) or various gas mixtures (hypoxia, n = 5; hyperoxia, n = 4; hypercapnia, n = 5; hypercapnia+hyperoxia, n = 5). Tonic TA EMG was observed throughout >90% of apneas (>6 s) in both non-rapid-eye-movement and rapid-eye-movement sleep, and when Di EMG frequency decreased in rapid-eye-movement sleep. In all but two fetuses, TA EMG was immediately inhibited when Di EMG appeared. Altering blood gases did not modify these results. In conclusion, Di EMG and TA EMG are well coordinated in late gestation in fetal lambs, except in a few cases. These findings may have consequences for understanding the pathogenesis of mixed/obstructive apneas of prematurity.

Laryngeal and abdominal muscle electrical activity during periodic breathing in nonsedated lambs.

We recently reported that glottic closure was present throughout central apneas in awake lambs. The present study tested whether glottic closure was also observed during periodic breathing (PB). We attempted to induce PB in 21 nonsedated lambs on return from hypocapnic hypoxia to room air. Airflow and thyroarytenoid (a laryngeal constrictor, n = 16), cricothyroid (a laryngeal dilator, n = 10), and abdominal (n = 9) muscle electrical activity (EMG) were monitored continuously. PB was observed in 16 lambs, with apneic phases in 8 lambs. Thyroarytenoid muscle EMG was observed at the nadir of PB, either throughout apnea or with prolonged expiration during the lowest respiratory efforts. Phasic inspiratory cricothyroid muscle EMG and phasic expiratory abdominal EMG disappeared at the nadir of PB. Active glottic closure at the nadir of PB, without abdominal muscle contraction, could be a beneficial mechanism, preserving alveolar gas stores for continuing gas exchange during the apneic/hypopneic phase of PB. However, consequences of active glottic closure on ventilatory instability, either enhancing or reducing, are unknown.

Abolition of breathing rhythmicity in lambs by CO2 unloading in the first hours of life.

The mechanisms responsible for the maintenance of regular breathing after initiation of breathing at birth are still poorly understood. This study was designed to test the hypothesis that removing the chemical CO2 drive would abolish breathing rhythmicity in lambs in the first hours of life. A technique of graded CO2 removal through a veno-venous extracorporeal circuit was used in five unanesthetized lambs aged from 4 to 12 hours. In all lambs, CO2 unloading invariably resulted in sustained central apnea, after a decrease in Paco, of 6.9 +/- 5.7 Torr. We were unable to find a significant relationship between the decrease in PaCO2 and PaO2 (range 35-275 Torr) at onset of apnea. During apnea, the passage from behavioral quiet sleep to arousal or to active sleep was marked by transient and weak breathing movements. We conclude that the CO2 drive, but not the behavioral states, is a major factor for maintaining breathing rhythmicity in lambs in the first hours of life.

Influence of sleep states on laryngeal and abdominal muscle response to upper airway occlusion in lambs.

This study was aimed at describing abdominal and laryngeal muscle responses to upper airway occlusion (UAO) in early life and the effect of sleep states on these responses. Twelve nonsedated, 9-26-d-old lambs were studied. We simultaneously recorded 1) airflow (pneumotachograph + face mask); 2) sleep states (electrocorticogram and electrooculogram); 3) abdominal muscle (external obliquus) electromyogram (EMG); and 4) glottic constrictor (thyroarytenoid) and dilator (posterior cricoarytenoid and cricothyroid) muscle EMGs. The pneumotachograph was repeatedly occluded for 15-30 s in wakefulness and natural sleep. We analyzed 90 occlusions during wakefulness (11 lambs), 28 during non-rapid eye movement (nREM) sleep (six lambs), and 23 during rapid eye movement (REM) sleep (five lambs). A phasic expiratory external obliquus EMG was present during baseline and progressively increased throughout UAO in wakefulness and nREM sleep, but not in REM sleep. Phasic thyroarytenoid EMG progressively increased during inspiratory efforts throughout UAO in wakefulness and nREM sleep, paralleling the increase in glottic dilator (posterior cricoarytenoid and cricothyroid) EMG. In contrast, glottic muscle response to UAO in REM sleep was severely blunted or disorganized by frequent swallowing movements. We conclude that UAO triggers complex and coordinated laryngeal and abdominal muscle responses during wakefulness and nREM sleep in lambs; these responses are largely absent, however, in REM sleep. These unique results, together with the defective arousal response in REM sleep, suggest that vulnerability to airway occlusion could be increased during REM sleep in early life. Possible implications for understanding severe postnatal apneas are discussed.

Inferior pharyngeal constrictor electromyographic activity during permeability pulmonary edema in lambs.

Newborn mammals exhibit an active expiratory upper airway closure during the first hours of extrauterine life. We have recently shown that permeability pulmonary edema led to active expiratory glottic closure in awake newborn lambs while hypoxia (inspired O2 fraction 8%; 15 min) did not. In the present study, we tested the hypothesis that expiratory glottic closure was accompanied by an increase in pharyngeal constrictor muscle expiratory electromyographic (EMG) activity. We studied seven awake nonsedated lambs aged 8-20 days. Airflow (facial mask + pneumotachograph), blood gases (arterial catheter), and EMG activity of both the thyroarytenoid muscle (a glottic adductor) and the inferior pharyngeal constrictor muscle were recorded before and after intravenous injection of halothane (0.05 ml/kg) to induce a permeability pulmonary edema. A central apnea (duration 15 s to 5 min) with continuous thyroarytenoid and inferior pharyngeal constrictor activity was observed within seconds after halothane injection. One lamb died despite rescuing maneuvers. An expiratory phasic thyroarytenoid and inferior pharyngeal constrictor muscle activity with simultaneous zero airflow gradually took place and, by 30 min after halothane injection, was present at each expiration in the six remaining lambs. Expiratory glottic and pharyngeal constrictor muscle EMG activity was subsequently present during the whole study period (1.5-5 h), even after correction of the initial hypoxia. Permeability lung edema was present at postmortem examination in all seven lambs. We conclude that a permeability pulmonary edema induced by intravenous halothane in non-sedated lambs enhances both glottic and pharyngeal constrictor muscle expiratory EMG. We hypothesize that expiratory contraction of the inferior pharyngeal constrictor muscle could participate in the active expiratory upper airway closure; this, in turn, might improve alveolocapillary gas exchange by increasing the end-expiratory lung volume.

Prolonged active glottic closure after barbiturate-induced respiratory arrest in lambs.

We recently showed that the glottis is actively closed throughout post-hyperventilation, hypocapnic central apnea in lambs. The present study was designed to test whether the glottis is also closed in non-hypocapnic central apnea. Twenty-seven lambs aged 2 to 30 days were intravenously injected with 325 mg of sodium pentobarbital, so as to obtain breathing arrest. Airflow was recorded via a facial mask and pneumotachograph, along with the electromyographic activity (EMG) of the thyroarytenoid muscle (TA, a glottic adductor). With the onset of apnea, continuous TA EMG appeared in a few seconds and rose rapidly. Brief inspiratory gasps were observed in eight lambs, and TA EMG was abruptly inhibited for the exact duration of the gasps. The continuous TA EMG then disappeared after 115 to 230 sec. We conclude that the glottis is actively closed during fatal non-hypocapnic central apnea in lambs. Our data suggest that active glottic closure occurs with major depression of central inspiratory drive.

Postnatal maturation of peripheral chemoreceptor ventilatory response to O2 and CO2 in newborn lambs.

Although studies on lambs have shown that carotid body sensitivity to O2 is reset postnatally, it is still unknown whether O2 and CO2 peripheral chemoreflexes undergo parallel postnatal maturation. The present study was designed to analyze maturation of O2 and CO2 peripheral chemoreflexes in 10 lambs at < 24 h and at 12 days of age. We measured the ventilatory (VE) response to three tidal breaths of pure N2 or 13% CO2 in air. Overall, the N2 peripheral chemoreflex increased significantly with maturation [VE/end-tidal O2 (ml.min-1.kg-1.Torr-1) = 2.94 +/- 0.91 at < 24 h vs. 5.13 +/- 0.59 at 12 days, P < 0.05], whereas the CO2 peripheral chemoreflex did not change (VE/end-tidal CO2 = 7.04 +/- 0.98 at < 24 h vs. 7.75 +/- 1.07 at 12 days, not significant). We conclude that the CO2 peripheral chemoreflex does not change in awake lambs within the time frame studied, in contrast to a marked postnatal maturation of the O2 peripheral chemoreflex. The different time courses of O2 and CO2 peripheral chemoreflex maturation support the concept that carotid body sensitivities to O2 and CO2 do not depend on the same basic mechanisms.

Active expiratory glottic closure during permeability pulmonary edema in nonsedated lambs.

It has long been claimed that the active expiratory glottic closure observed in newborns, especially during hyaline membrane disease, is related to hypoxia. However, we recently showed that hypoxia does not lead to active expiratory glottic closure in nonsedated lambs. In this study, we test the hypothesis that glottic closure is related to an excess of lung water present at birth. We studied 17 nonsedated lambs after inducing a permeability pulmonary edema via intravenous of either oleic acid (8 lambs) or halothane (9 lambs). We recorded airflow via a facial mask and pneumotachograph, as well as the electromyographic activity (EMG) of the thyroarytenoid muscle (TA), a glottic adductor. Blood gases were measured in 8 lambs via a brachial artery catheter. We identified laryngeal expiratory airflow braking on the breath-by-breath computed flow-volume loop and TA expiratory EMG as evidence of active expiratory glottic adduction. After the injection of oleic acid or halothane, an active expiratory glottic closure was recorded in all lambs but 1, usually throughout the recording period (60 to 300 min). The active expiratory glottic closure was not inhibited after correction of the hypoxia. We conclude that, in nonsedated lambs, a permeability pulmonary edema induces an active expiratory glottic closure. We hypothesize that the expiratory glottic closure commonly observed in newborns could help to ameliorate the alveolocapillary gas exchange by reopening the flooded alveoli.

Laryngeal response to hypoxia in awake lambs during the first postnatal days.

We recently showed that hypoxia does not induce active expiratory glottic adduction in awake lambs more than 10 d old. To reconcile our results with previous data from other researchers, we hypothesized that an active expiratory glottic closure might still be part of the response to hypoxia in the very first postnatal days. The present study was undertaken to test this hypothesis. We studied 22 awake, nonsedated lambs during hypocapnic hypoxia (fraction of inspired O2 = 0.08 during 15 min) induced during the first 72 h of postnatal life. We recorded airflow via a facial mask and pneumotachograph, along with the electromyographic activity (EMG) of the thyroarytenoid muscle (a glottic adductor) in 10 lambs. We also recorded the EMG of both the posterior cricoarytenoid (n = 4) and cricothyroid (n = 5) muscles (glottic abductors), as well as the abdominal muscles (n = 4). We identified typical expiratory airflow braking on the breath-by-breath computed flow-volume loop and thyroarytenoid muscle expiratory EMG as evidence of active expiratory glottic adduction. We found that hypoxia induced a biphasic ventilatory response, with an early peak and a subsequent decrease, and that active expiratory glottic adduction was absent during baseline room-air breathing and hypoxia. We also found that the glottic abductor phasic inspiratory and tonic expiratory EMG as well as the abdominal muscle phasic expiratory EMG, all of which were present during baseline recording, increased during hypoxia. We conclude that hypoxia does not induce expiratory glottic closure in the very first days of life in awake lambs.(ABSTRACT TRUNCATED AT 250 WORDS)

Thyroarytenoid muscle activity during hypocapnic central apneas in awake nonsedated lambs.

In this study, we examined whether the glottis is open or closed during central apnea and the effect of arterial PO2 (PaO2) on this control. We hyperventilated nine 11- to 30-day-old awake nonsedated lambs via a tracheostomy for 1 min to induce central apnea. Four gas mixtures (8, 15, 21, and 30% O2) were used. At the end of the hyperventilation period, the lambs were allowed to breathe spontaneously through intact upper airways. Using a pneumotachograph attached to a face mask, we measured airflow, and we continuously recorded electromyographic (EMG) activity of the thyroarytenoid (TA), the main glottic adductor muscle. We also studied the lateral cricoarytenoid muscle (LCA, laryngeal adductor), the posterior cricoarytenoid muscle (PCA, laryngeal abductor), the cricothyroid muscle (CT), and the diaphragm. We found that hyperventilation consistently induced hypocapnic central apnea in all nine lambs in hyperoxic conditions [30% inspiratory fraction of O2 (FIO2)], in eight of nine lambs in normoxia or mild hypoxia (15 and 21% FIO2), and in four of seven lambs in hypoxia (8% FIO2). During baseline room air breathing, there was no glottic adductor muscle expiratory EMG activity or expiratory airflow braking. Continuous TA EMG activity began early during hyperventilation and continued throughout the central apnea, regardless of PaO2. The first subsequent breathing efforts were marked by expiratory flow braking and expiratory activity of the TA. The LCA and the TA demonstrated the same EMG activity pattern.(ABSTRACT TRUNCATED AT 250 WORDS)

Vagal and chemoreceptor influences on abdominal muscle activity in awake lambs during hypoxia.

The ventilatory response to hypoxia is a complex phenomenon involving several control mechanisms. We designed this study to examine the dynamic control of abdominal muscle expiratory electromyogram (EMG) activity during room-air breathing and hypoxia and then to analyze the relative contribution of the chemoreceptors and vagal afferents. We studied 12 11- to 22-day-old awake nonsedated lambs, six intact and six vagotomized. To assess the dynamic influence of peripheral chemoreceptors on abdominal muscle expiratory activity, we performed transient testing of peripheral chemoreceptor function (pure O2 and N2 inhalation, KCN injection). To assess the influence of central chemoreceptor afferents, we compared results obtained during hypocapnic and isocapnic 15-min hypoxic runs (fractional concentration of inspired O2 0.08) in each lamb. We also compared results obtained in intact and vagotomized lambs so that the importance of vagal afferents could be assessed. We consistently observed abdominal muscle expiratory EMG activity in each lamb, whether intact or vagotomized, during baseline room air breathing; further recruitment was observed during hypoxia. We also consistently observed abdominal muscle expiratory recruitment during hypocapnic hypoxia in each lamb, although it was significantly less marked than during isocapnic hypoxia. Our transient testing of peripheral chemoreceptor function showed, furthermore, that peripheral chemoreceptor afferents dynamically modulate abdominal muscle expiratory activity. Thus, during hypoxia in 11- to 22-day-old awake nonsedated lambs, increased afferent information from peripheral chemoreceptors forcefully enhances abdominal muscle expiratory activity.(ABSTRACT TRUNCATED AT 250 WORDS)