Respiration Physiology, 80 (1990) 193-202 193
Elsevier
RESP 01649
Influence of lung volume and rib cage configuration
on transdiaphragrnatic pressure during phrenic
nerve stimulation in man
Anne Mier, Conor Brophy, John Moxham and Malcolm Green
Brompton Hospital, London, U.K.
(Accepted 16 February 1990)
Abstract. Transdiaphragmatic pressure was recorded during bilateral supramaximal percutaneous phrenic
nerve stimulation at 1 Hz (twitch Pdi) to investigate the effect of lung volume and rib cage configuration
on diaphragm contractility in man. Stimulations were performed in 5 normal supine subjects at resting end
expiration (FRC) and at lung volumes above and below FRC, during relaxation against a closed airway and
during isovolume manoeuvres.Twitch Pdi at FRC was 24.4 cm H20. At lung volumes above FRC, twitch
Pdi decreased by 7.04 + 3.2 cm HaO per litre of volume change. At lung volumes below FRC, twitch Pdi
increased by 12.4 _+8.6 cm HzO per litre of volume change. When the diaphragm was lengthened during
an isovolume manoeuvre at FRC, twitch Pdi increased. A similar relationship between lung volume and
twitch Pdi was obtained during stimulations performed with abdominal binding. These results demonstrate
that the pressure developed by the diaphragm during phrenic nerve stimulation is significantly affected both
by increases and decreases in lung volume and by the rib cage configuration at which stimulation is
performed.
Animal, man; Diaphragm, contractility, dependence on lung volume; Lung volume, influence on
diaphragmatic contractility; Phrenic nerve, stimulation, transdiaphragmatic pressure; Pressure, esophageal,
gastric, transdiaphragmatic; Rib cage configuration, influence on diaphragm contractility; Technique in
respiratory physiology,phrenic nerve stimulation (electric)
Previous studies both in vitro and in vivo have demonstrated that the force developed by
the diaphragm depends on muscle length. The tension generated by the diaphragm has
been noted to decrease as diaphragm length shortens and the length tension properties
of the mammalian diaphragm in vitro have been shown to be similar to those of intact
limb muscles and to be similar between species (McCully and Faulkner, 1983). Other
studies in cats and man have demonstrated that twitch tension during submaximal
unilateral phrenic nerve stimulation decreases as lung volume increases (Pengelly et al.,
1971). The force-length relationship of the diaphragm was further demonstrated during
Correspondence to: A. Mier, Department of Medicine, Charing Cross Hospital, Fulham Palace Road,
London W6, U.K.
0034-5687/90/$03.50 © 1990 Elsevier Science Publishers B.V. (Biomedical Division)