J.Jpn. Surg. Soc.. 92(9): 1367-1370, 1991
Report on the annual meeting
EFFECTS OF DIAPHRAGM PLICATION FOR PHRENIC NERVE PARALYSIS ON RESPIRATORY MECHANICS AND DIAPHRAGM FUNCTION
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First Department of Surgery, Osaka University Medical School, Osaka, Japan Shinichi Takeda, Kazuya Nakahara, Yoshitaka Fujii, Shinichiro Miyoshi, Takatoshi Mizuta, Masato Minami, Hikaru Matsuda |
Study 1 : We performed thoracotomy (BASELINE), left phrenicotomy (INJURY) and left diaphragm plication (PLICATION) in ten dogs. After chest was closed in each condition, measured were the tidal volume (TV), respiratory rate (f), esophageal and gastric pressure swing (⊿Pes, ⊿Pga), dynamic compliance (Cdyn) the ratio of gastric to esophageal pressure swing (⊿Pga/⊿Pes) and the work of breathing per liter (WOB/L) under stable spontaneous breathing.
Study 2 : In eight other left-phrenicotomized dogs, Pdi and fractional shortening of the costal diaphragm during contralateral electrophrenic stimulation were measured before and after plication.
After plication TV, ⊿Pga/⊿Pes, Cdyn, Pdi and fractional shortening during stimulation increased significantly, whereas Pes and WOB/L decreased significantly compared with INJURY condition.
In conclusion unilateral diaphragm plication after paralysis improves the intact hemidiaphragm contractility and diaphragmatic contribution to breathing.
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