Complete glottic closure during central apnea in lambs.

OBJECTIVE

The objectives of this study were threefold: to document complete glottic closure during artificially induced central apnea in lambs; to unequivocally confirm that thyroarytenoid muscle electrical activity during central apneas in lambs reflects complete glottic closure; and to evaluate the physiologic significance of this phenomenon in artificially induced central apneas in lambs.

METHODS

We recorded thyroarytenoid (TA) muscle EMG, subglottic pressure, and lung volume simultaneously with direct endoscopic vision of the glottis from beneath on nine 11- to 15-day-old lambs during artificially induced central apneas.

RESULTS

Thirty-eight central apneas were induced. Complete glottic closure was present on 35/38 (92%) of these apneas. Complete glottic closure was always paralleled by thyroarytenoid muscle electromyogram (EMG) activity (35/38). In no instance was TA EMG recorded without complete glottic closure. Moreover, positive subglottic pressure and maintenance of lung volume above functional residual capacity were observed in 27/30 (90%) and 18/19 (95%), respectively, of these apneas where complete glottic closure was present.

CONCLUSIONS

Complete glottic closure is present throughout most artificially induced central apneas in lambs. Complete glottic closure is paralleled by TA EMG in artificially induced central apneas. Thyroarytenoid muscle electromyographic activity is a reliable way to document complete glottic closure during apneas, especially in the presence of positive subglottic pressure. These observations suggest that complete glottic closure could be a physiologic mechanism aimed at maintaining higher lung volumes to improve gas exchange during central apneas.