Different modes of assisted ventilation were investigated in cats before and after lung lavage and after instillation of surfactant. The activity of single units of slowly adapting pulmonary stretch receptors (PSRs) in the vagal nerve and the integrated phrenic nerve activity were recorded. The instantaneous impulse frequency (fimp) of PSRs was calculated and related to transpulmonary pressure (Ptp), tidal volume (Vt) and the calculated energy storage of the lung (ΣP*ΔV). Respiratory rate (RR), inspiratory and expiratory time, and Vt were measured, and their coefficients of variation were calculated. During assist control (A/C) ventilation with different pressure waveforms, PNA was shorter and lower in amplitude with squarewave pressure waveform than with linear and sinusoidal pressure waveforms in cats with normal lungs, concomitantly with earlier peak fimp during inspiration and prolonged fimp during expiration. The type of pressure waveform can thus influence the spontaneous breathing effort during A/C ventilation. Proportional assist ventilation (PAV) is a new mode of assisted ventilation which servo-controls the applied airway pressure continuously in proportion to the breathing effort. After lung lavage and surfactant instillation, PAV improves ventilation markedly, with lower PNA and oesophageal pressure deflection and higher RR and variability of breathing, compared to CPAP. In addition, an earlier and higher maximal fimp was observed during PAV. Under conditions of low work and maintained control of breathing, PAV seems to be an attractive mode of ventilatory support. Low-threshold (LT) and high-threshold (HT) PSRs respond to the surfactant content of the lung partly independent of Ptp and Vt in spontaneously breathing cats, implying a possible effect of surfactant on PSRs. The PSR fimp normalized to ΣP*ΔV confirmed these findings and showed that LT and HT PSRs are intrinsically the same. After instillation of surfactant, compliance and PSR activity increased, but the breathing still remained shallow and rapid, suggesting a control of breathing less dominated by PSR activity.

No description available.

The breathing pattern of preterm infants is immature and is associated with a variety of reflexes. In a patient on the ventilator these reflexes interfere with spontaneous breathing. A better understanding of the immature control of breathing could lead to further improvements in ventilatory techniques. This thesis concerns studies of pulmonary stretch receptor (PSR) and phrenic nerve activity as part of the regulation of breathing in an animal model. During assist/control ventilation with three different inspiratory pressure waveforms in animals with healthy lungs, squarewave pressure waveform strongly inhibits spontaneous inspiratory activity. During partial liquid ventilation (PLV) in animals with healthy lungs, all PSRs studied maintained their phasic character, with increased impulse frequency during inspiration. PSR activity was not higher during PLV than during gas ventilation (GV), indicating that there was no extensive stretching of the lung during PLV. During proportional assist ventilation (PAV) the applied airway pressure is servo-controlled proportionally to the ongoing breathing effort, thereby interacting with the activity of PSRs. Peak PSR activity was higher and occurred earlier during PAV than during CPAP. The regulation of breathing is maintained during PAV in surfactant-depleted animals before and early after surfactant instillation, with a higher ventilatory response and a lower breathing effort than during CPAP in both conditions. Both lung mechanics and gas exchange influence the regulation of breathing. Inhibition of inspiratory activity occurred at a lower arterial pH and a higher PaCO2 during PLV than during GV in animals with surfactant-depleted lungs, which might be related to recruitment of a larger number of pulmonary stretch receptors during PLV. In summary, selected aspects of the regulation of breathing were studied in an animal model with different ventilatory techniques under different lung conditions similar to those that can occur in infants.

Submitted by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T14:10:10Z No. of bitstreams: 1 DissWIF.pdf: 2975197 bytes, checksum: 0039c1cb759b3d42c9bd5b659146af6a (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T14:10:20Z (GMT) No. of bitstreams: 1 DissWIF.pdf: 2975197 bytes, checksum: 0039c1cb759b3d42c9bd5b659146af6a (MD5) / Approved for entry into archive by Ronildo Prado (ronisp@ufscar.br) on 2017-08-10T14:10:28Z (GMT) No. of bitstreams: 1 DissWIF.pdf: 2975197 bytes, checksum: 0039c1cb759b3d42c9bd5b659146af6a (MD5) / Made available in DSpace on 2017-08-10T14:10:35Z (GMT). No. of bitstreams: 1 DissWIF.pdf: 2975197 bytes, checksum: 0039c1cb759b3d42c9bd5b659146af6a (MD5) Previous issue date: 2013-08-26 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / The nucleus of the solitary tract (NTS) is the primary synaptic site of the peripheral baroreceptors and chemoreceptors. It has been shown that acetylcholine (ACh) microinjected into the NTS of rats induces hypotension and bradycardia. However, the contribution of cholinergic mechanisms at different NTS subnuclei (intermediate and commissural) as well as the cholinergic receptors blockade on the control of sympathetic (SNA) and phrenic (PNA) nerve activities have not been studied yet. In this study we assessed the role of ACh and its cholinergic receptors at the intermediate NTS (iNTS) and commissural NTS (cNTS) on the control of SNA, PNA and electrophysiological properties of these subnuclei neurons, as well as on baro and chemoreflex responses. Decorticated arterially-perfused in situ preparations of male juvenile rats were used to record SNA and PNA. Microinjections of ACh and cholinergic antagonists were performed into the iNTS or cNTS. Coronal slices of the brainstem containing either cNTS or iNTS subnuclei were obtained from male juvenile rats and used in whole cell patch clamp – current clamp recordings. It was observed that ACh microinjected into the iNTS inhibited both SNA and PNA. These effects were reduced by the pre-treatment with atropine (muscarinic antagonist) or mecamylamine (nicotinic antagonist). The cholinergic antagonists into the iNTS did not change the effects on SNA and PNA induced by baro and chemoreflex activation. In contrast, microinjections of ACh into the cNTS did not induce changes in SNA, but increased PNA. Despite the absence of changes in SNA, ACh into the cNTS changed the pattern of respiratory-sympathetic coupling. Both atropine and mecamylamine into the cNTS inhibited the ACh-induced tachypnea, but only mecamylamine inhibited the chemoreflex-induced tachypnea and the ACh-induced change in respiratory-sympathetic coupling. In vitro studies demonstrated that ACh promotes depolarization in both iNTS and cNTS neurons. Both muscarinic and nicotinic antagonism in the iNTS inhibited the ACh-induced depolarization. However, only nicotinic antagonist was effective in diminishing this response in the cNTS. The results suggest that ACh plays an important role in the control of cardiovascular and respiratory activities, with distinct functions between iNTS and cNTS. This cholinergic control involves activation of both muscarinic and nicotinic receptors within NTS, but only nicotinic receptors are involved in the chemoreflex tachypneic response. / O núcleo do trato solitário (NTS) é o sítio primário de aferências dos barorreceptores arteriais e quimiorreceptores. Sabe-se que a acetilcolina (ACh) injetada no NTS de ratos provoca hipotensão e bradicardia. Entretanto, não se sabe até o momento qual o papel do sistema colinérgico nos diferentes subnúcleos do NTS (intermediário ou comissural) ou o bloqueio de seus receptores na atividade simpática (SNA) ou na atividade do frênico (PNA). No presente estudo avaliamos os efeitos da ACh e seus receptores no NTS intermediário (NTSi) e comissural (NTSc) sobre a SNA, PNA e sobre as propriedades eletrofisiológicas dos neurônios desses subnúcleos, bem como nas respostas do baro e quimiorreflexos. Preparações in situ decorticadas de ratos jovens foram utilizadas para registro da SNA e PNA, e ACh e antagonistas colinérgicos foram microinjetados no NTSi ou NTSc. Cortes coronais bulbares contendo o NTSi ou NTSc foram obtidos de ratos jovens e utilizados para registro de neurônios através da técnica whole cell patch clamp – current clamp. Foi observado que a microinjeção de ACh no NTSi inibe tanto a SNA quanto a PNA, sendo que tais efeitos são inibidos pelo tratamento com atropina (antagonista muscarínico) ou mecamilamina (antagonista nicotínico). Os antagonistas colinérgicos no NTSi não alteraram os efeitos na SNA e PNA induzidos pela ativação do baro e quimiorreflexos. Por outro lado, microinjeções de ACh no NTSc não altera a SNA mas promove aumento da PNA. Apesar de não alterar a SNA, a ACh no NTSc promove alterações no acoplamento simpato-respiratório. Tanto a atropina quanto a mecamilamina microinjetadas no NTSc inibiram a taquipnéia induzida pela ACh, mas apenas a mecamilamina inibiu a taquipnéia resultante do quimiorreflexo e a alteração no acoplamento simpato-respiratório induzida pela ACh no NTSc. Nos estudos in vitro, observamos que a ACh promove respostas de despolarização em neurônios tanto do NTSi quanto do NTSc. O bloqueio de receptores tanto nicotínicos quanto muscarínicos no NTSi diminui a despolarização evocada pela ACh. No entanto, apenas o antagonista nicotínico foi capaz de diminuir essa resposta no NTSc. Os resultados sugerem que a ACh desempenha um importante papel no controle cardiorrespiratório, com funções distintas entre NTSi e NTSc. Esse controle colinérgico envolve a ativação de receptores tanto nicotínicos quanto muscarínicos no NTS, mas apenas receptores nicotínicos estão envolvidos na resposta de taquipnéia do quimiorreflexo. / FAPESP: 2010/17218-0

O nervo depressor aórtico (NDA) é, primariamente, um conjunto de fibras aferentes que transmitem informações oriundas de alterações da pressão arterial (PA) a partir dos barorreceptores arteriais (mecanorreceptores localizados no arco da aorta ou seio carótico) aos centros de controle cardiovascular localizados no sistema nervoso central (SNC). Este mecanismo é responsável pela regulação reflexa da função cardíaca e vascular, promovendo ajustes nos centros vasoconstritor e vasodilatador, atuando simultaneamente sobre os sistemas simpático e parassimpático. Fato este que, contribui para o aumento da atividade vagal cardíaca e inibição de descargas simpáticas para vasos e coração, garantindo a manutenção dos níveis pressóricos dentro de uma faixa de normalidade. Diversos neurotransmissores foram descritos atuando nos centros de controle cardiocirculatório localizados no tronco encefálico, mais especificamente no bulbo, participando da regulação da PA. Nestas regiões centrais, os neurotransmissores glutamato, GABA (Àcido Gama Aminobutírico) e substância P (SP) foram amplamente investigados. Entretanto, em nenhum destes trabalhos foi realizado um estudo detalhado, investigando a presença da SP em nervos depressores aórticos de forma direta, sendo esta informação ainda desconhecida. Acredita-se que a SP seja um transmissor do reflexo barorreceptor, atuando na modulação deste circuito, na tentativa de atenuar elevações da pressão sanguínea. Existe portanto a necessidade de uma investigação morfológica e imunohistoquímica com o intuito de promover o esclarecimento sobre os neurotransmissores presentes no NDA. Os nervos frênicos foram utilizados como controle positivo, já que neste território a SP já se encontra caracterizada. Inúmeros são os estudos que descrevem a existência da SP em nervos frênicos, fato este que justifica a aplicação do referido nervo como controle do NDA, foco de estudo deste projeto. Baseados nestas necessidades, o objetivo do presente estudo foi primeiramente o de promover a padronização da técnica imunohistoquímica (IHQ), bem como a verificação da viabilidade de utilização do glutaraldeído à 2,5% como um fixativo primário, auxiliando na identificação de neurotransmissores dentro do sistema nervoso periférico. Em seguida, a identificação e quantificação da SP em NDA de ratos normotensos através do método imunohistoquímico indireto (3,3\'- Diaminobenzidina \"DAB\") foram realizados. O referido estudo foi desenvolvido em duas etapas. A primeira parte corresponde a padronização e otimização da técnica de imunohistoquímica em nervos frênicos de ratos Wistar através da localização e caracterização da SP e da enzima colina acetiltransferase (CAT). A segunda fase, trata-se da identificação e quantificação da SP no NDA, sendo este, um possível neurotransmissor ou neuromodulador do reflexo barorreceptor. Para este estudo foram utilizados no total 38 ratos da linhagem Wistar (Rattus Norvegicus), normotensos, com 20 semanas de idade, machos e fêmeas. Deste total, 16 animais machos foram destinados à padronização da técnica de IHQ em nervos frênicos. E para a caracterização e quantificação da SP no NDA foram utilizados 22 ratos Wistar, sendo 12 machos e 10 fêmeas. Nossos resultados demonstram de forma inédita a presença da SP em fibras amielínicas (tipo C) e fibras de pequeno diâmetro (A-delta) no NDA de forma bastante pontualizada em segmentos proximais e difusa distalmente, sugerindo a existência de subpopulações de fibras amielínicas do tipo C. Estes achados confirmam inúmeras suposições de que a SP atue como um dos neurotransmissores de aferências barorreceptoras, podendo participar na modulação do Sistema Nervoso Autônomo (SNA), uma vez que encontra-se localizada em centros responsáveis pela regulação reflexa da PA. Adicionalmente, a análise do percentual de marcação positiva à SP entre os gêneros apresentou um aparente predomínio da SP em machos mas sem diferença significativa entre os grupos. De forma semelhante, a padronização imunohistoquímica em cortes transversais e longitudinais de nervos frênicos apresentaram uma imunomarcação positiva e aleatória da SP em conjuntos de fibras amielínicas (tipo C) e em fibras de pequeno diâmetro localizadas próximo a periferia do espaço endoneural, corroborando com a localização relatada em estudos morfológicos e ultraestruturais, assegurando a especificidade e a reprodutibilidade do método. Distintamente, as fibras de grande e médio diâmetro (A-alfa, beta e gama), consideradas fibras mielinizadas de condução rápida, foram imunorreativas à CAT em nervos frênicos. Por fim, espera-se que a identificação deste neuropeptídeo sirva de gatilho para que futuras pesquisas envolvendo a liberação de neurotransmissores em aferências barorreceptoras sejam explorados. Fato este, que contribuirá para a agregação de informações pertinentes à modulação ou transmissão da informação neural, propiciando desta forma melhor entendimento da comunicação e atividades barorreflexas associadas a mecanismos cardiovasculares. / The aortic depressor nerve (ADN) is primarily a set of afferent fibers that transmit derived information of changes in arterial blood pressure (BP) from arterial baroreceptors (mechanoreceptors located in the aortic arch and carotid sinus) to sites of cardiovascular control located into central nervous system (CNS). This mechanism is responsible for the reflex regulation of cardiac and vascular function, promoting adjustments of vasoconstrictor and vasodilator centers, simultaneously acting on the sympathetic and parasympathetic systems. In addition, contributes to increased cardiac vagal activity and inhibition of sympathetic discharges to vessels and heart, ensuring the maintenance of blood pressure levels within the normal range. Many neurotransmitters have been described operating in cardio-circulatory control centers located in the brainstem, more specifically in the bulb, participating in the regulation of BP. In these central regions, the neurotransmitters glutamate, GABA (Gamma Aminobutyric Acid) and substance P (SP) have been widely investigated. However, none of these works was carried out a detailed study, investigating the presence of SP in aortic depressor nerves directly, and this information is still unknown. It is believed that SP can be a transmitter at the synapse of the baroreceptor reflex, operating in the modulation of this circuit in an attempt to attenuate elevation of blood pressure. Therefore, there is a need to investigate a morphological and immunohistochemical approach in order to promote the clarification on the present neurotransmitters into ADN. The phrenic nerves were used as a positive control, already as substance P (SP) is characterized in this territory. There have been numerous studies describing the existence of SP in phrenic nerves, a fact that justifies the application of the nerve as control of the ADN, study focus of this project. Based on these requirements, the aim of the present study is two-fold. Firstly, it attempts to promote the standardization of the immunohistochemical (IHC) technique as well as the verification of the feasibility of using glutaraldehyde fixative as a primary, assisting in the identification of neurotransmitters in the peripheral nervous system (PNS). Subsequently, the identification and quantification of SP immunoreactivity in the ADN of normotensive rats by indirect immunohistochemical method (3,3\'-Diaminobenzidine \"DAB\") were done. The study was developed in two stages. The first part corresponds to standardization and optimization of immunohistochemical technique in phrenic nerves of Wistar rats through location and characterization of the SP and enzyme choline acetyltransferase (ChAT). The second phase is about the identification and quantification of the SP into ADN, being a possible neurotransmitter or neuromodulator from the baroreceptor reflex. For this study we used a total of 38 Wistar rats (Rattus norvegicus), normotensive, 20 weeks old, male and female. From this total, 16 male animals were used for standardization of IHC technique in the phrenic nerves. Nonetheless, for the characterization and quantification of SP in ADN were used 22 Wistar rats, 12 males and 10 females. Our results showed an unprecedented manner the presence of SP in unmyelinated fibers (type C) and small diameter fibers (A-delta) into ADN, being quite focused on proximal segments and diffuse distally, suggesting the existence of subsets of unmyelinated fibers. These findings confirm numerous assumptions that the SP acts as a neurotransmitter from afferent baroreceptor and may participate in the modulation of the Autonomic Nervous System (ANS), since it is located in centers responsible for regulating reflex of BP. Further, an analysis of the percentage of positive SP staining between genders, presented an apparent predominance of SP in males but no significant difference between the groups were found. Similarly, IHC standardization in transverse and longitudinal sections of phrenic nerves showed a positive random and immunostaining of SP in sets of unmyelinated fibers (type C) and small diameter fibers located near the periphery of endoneural space, corroborating location reported on morphological and ultrastructural studies, ensuring the specificity and reproducibility of the method. Distinctly, the fibers of large and medium diameters (A-alpha, beta and gamma), considered myelinated fibers of fast conducting, were immunoreactive to ChAT in phrenic nerves. Finally, it is expected that the identification of neuropeptide serve as a trigger for that future studies involving the release of neurotransmitters into afferent baroreceptors be explored. These results could contribute to the aggregation of relevant information for the modulation and transmission of neural information, thus providing better understanding of communication and baroreflex activities associated with cardiovascular mechanisms.