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Laboratory of Cardiorespiratory Physiology, Brussels School of Medicine; and Chest Service, Erasme University Hospital, Brussels, Belgium
Submitted 17 December 2007 ; accepted in final form 3 March 2008
Although ascites causes abdominal expansion, its effects on abdominal muscle function are uncertain. In the present study, progressively increasing ascites was induced in supine anesthetized dogs, and the changes in abdominal (
Pab) and airway opening (
Pao) pressure obtained during stimulation of the internal oblique and transversus abdominis muscles were measured; the changes in internal oblique muscle length were also measured. As ascites increased from 0 to 100 ml/kg body wt, Pab and muscle length during relaxation increased.
Pab also showed a threefold increase (P < 0.001). However,
Pao decreased (P < 0.001). When ascites increased further to 200 ml/kg, resting muscle length continued to increase and muscle shortening during stimulation became very small so that active muscle length was 155% of the resting muscle length in the control condition. Concomitantly,
Pab returned to the control value, and
Pao continued to decrease. Similar results were obtained with the animals in the head-up posture, although the decrease in
Pao appeared only when ascites was greater than 125 ml/kg. It is concluded that 1) ascites adversely affects the expiratory action of the abdominal muscles on the lung; 2) this effect results primarily from the increase in diaphragm elastance; and 3) when ascites is severe, the abdomen cross-sectional area is also increased and the abdominal muscles are excessively lengthened so that their active pressure-generating ability itself is reduced.
respiratory muscles; chest wall mechanics; length-tension characteristics; muscle overstretching
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