Effect of surface tension of mucosal lining liquid on upper airway mechanics in anesthetized humans

Jason P Kirkness; Peter R Eastwood; Irene Szollosi; Peter R Platt; John R Wheatley; Terence C Amis; David R Hillman

doi:10.1152/japplphysiol.01198.2002

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Effect of surface tension of mucosal lining liquid on upper airway mechanics in anesthetized humans

Journal article

Peer reviewed

Effect of surface tension of mucosal lining liquid on upper airway mechanics in anesthetized humans

Jason P Kirkness, Peter R Eastwood, Irene Szollosi, Peter R Platt, John R Wheatley, Terence C Amis and David R Hillman

Journal of applied physiology (1985), Vol.95(1), pp.357-363

2003

DOI: https://doi.org/10.1152/japplphysiol.01198.2002

PMID: 12626492

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Abstract

obstructive sleep apnea

general anesthesia

Upper airway (UA) patency may be influenced by surface tension (γ) operating within the (UAL). We examined the role of γ of UAL in the maintenance of UA patency in eight isoflurane-anesthetized supine human subjects breathing via a nasal mask connected to a pneumotachograph attached to a pressure delivery system. We evaluated 1) mask pressure at which the UA closed (Pcrit), 2) UA resistance upstream from the site of UA collapse (RUS), and 3) mask pressure at which the UA reopened (Po). A multiple pressure-transducer catheter was used to identify the site of airway closure (velopharyngeal in all subjects). UAL samples (0.2 μl) were collected, and the γ of UAL was determined by using the “pull-off force” technique. Studies were performed before and after the intrapharyngeal instillation of 5 ml of exogenous surfactant (Exosurf, Glaxo Smith Kline). The γ of UAL decreased from 61.9 ± 4.1 (control) to 50.3 ± 5.0 mN/m (surfactant; P < 0.02). Changes in Po, RUS, and Po - Pcrit (change = control - surfactant) were positively correlated with changes in γ (r2 > 0.6; P < 0.02) but not with changes in Pcrit (r2 = 0.4; P > 0.9). In addition, mean peak inspiratory airflow (no flow limitation) significantly increased (P < 0.04) from 0.31 ± 0.06 (control) to 0.36 ± 0.06 l/s (surfactant). These findings suggest that γ of UAL exerts a force on the UA wall that hinders airway opening. Instillation of exogenous surfactant into the UA lowers the γ of UAL, thus increasing UA patency and augmenting reopening of the collapsed airway.

Details

Title: Effect of surface tension of mucosal lining liquid on upper airway mechanics in anesthetized humans
Authors/Creators: Jason P Kirkness - Westmead Hospital
Peter R Eastwood - Sir Charles Gairdner Hospital
Irene Szollosi - The University of Western Australia
Peter R Platt - The University of Western Australia
John R Wheatley - Westmead Hospital
Terence C Amis - The University of Sydney
David R Hillman - The University of Western Australia
Publication Details: Journal of applied physiology (1985), Vol.95(1), pp.357-363
Publisher: American Physiological Society
Identifiers: 991005592765907891
Murdoch Affiliation: Vice Chancellery
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.137 Sleep Science & Circadian Systems; 1.137.382 Obstructive Sleep Apnea
Web Of Science research areas: Physiology; Sport Sciences
ESI research areas: Biology & Biochemistry