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Related Experiment Videos

Diaphragmatic contractility after upper abdominal surgery.

B Dureuil, N Viirès, J P Cantineau

    Journal of Applied Physiology (Bethesda, Md. : 1985)
    |November 1, 1986
    PubMed
    Summary
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    Postoperative diaphragmatic dysfunction after upper abdominal surgery is not due to impaired diaphragm contractility. This diaphragmatic dysfunction likely stems from peripheral reflex inhibition of phrenic nerve output.

    Area of Science:

    • Physiology
    • Surgical Medicine
    • Respiratory Medicine

    Background:

    • Postoperative diaphragmatic dysfunction is a known complication following upper abdominal surgery.
    • The exact mechanisms underlying this dysfunction, particularly the role of diaphragmatic contractility, remain unclear.

    Purpose of the Study:

    • To investigate whether impaired diaphragmatic contractility contributes to diaphragmatic dysfunction after upper abdominal surgery.
    • To differentiate between intrinsic diaphragmatic contractility issues and other potential causes of dysfunction.

    Main Methods:

    • Studied five patients undergoing upper abdominal surgery.
    • Measured vital capacity (VC), functional residual capacity (FRC), and forced expiratory volume in 1 second (FEV1) preoperatively and 4 hours postoperatively.

    Related Experiment Videos

  • Assessed diaphragmatic function using the ratio of changes in gastric pressure (delta Pga) to changes in transdiaphragmatic pressure (delta Pdi), and diaphragm contractility via transdiaphragmatic pressure generated during phrenic nerve stimulation (Pdi stim).

    • Main Results:

    • All patients exhibited diaphragmatic dysfunction post-surgery, evidenced by a significant decrease in the delta Pga/delta Pdi ratio (P < 0.01).
    • Vital capacity (VC) also significantly decreased post-surgery (P < 0.01).
    • No significant changes were observed in functional residual capacity (FRC) or diaphragm contractility (Pdi stim) post-surgery.

    Conclusions:

    • Diaphragm contractility is not impaired after upper abdominal surgery.
    • Postoperative diaphragmatic dysfunction appears secondary to mechanisms like peripheral reflex inhibition of phrenic nerve output.
    • Further research should explore these reflex pathways in the context of diaphragmatic dysfunction.