Pharmacotherapy of the Respiratory Muscle

  • M. Aubier
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 15)


The respiratory system consists of a gas-exchanging organ, the lungs and a pump that ventilates them. The pump consists of the chest wall, which includes the rib cage, the respiratory muscles, and the respiratory centers in the central nervous system which control the diaphragm and the muscles used to expand the chest wall during breathing. The pump is the working or active part of the respiratory system, the lungs being merely passively inflated when the respiratory muscles contracts. The pump is just as vital as the heart, since without it, the lungs would obviously be unable to function, and arterial blood gas homeostasis would not be maintained.


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Respiratory Muscle Respiratory Muscle Function Transdiaphragmatic Pressure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Rochester DF (1980) Respiratory disease: Attention turns to the pump. Am J Med 81:803–805CrossRefGoogle Scholar
  2. 2.
    De Troyer A, Estenne M, Yenault JC (1980) Disturbance of respiratory muscle function in patients with mitral valve disease. Am J Med 69:867–873PubMedCrossRefGoogle Scholar
  3. 3.
    Adams RJ, Schwartz A (1980) Comparative mechanisms for concentration of cardiac skeletal muscle. Chest 78:123–133PubMedGoogle Scholar
  4. 4.
    Aubier M, Viires N, Piquet J, et al (1985) Effects of hypocalcemia on diaphragmatic strength generation. J Appl Physiol 58:2053–2061Google Scholar
  5. 5.
    Viires N, Murciano D, Seta JP, Dureuil B, Pariente R, Aubier M (1988) Effects of Ca2+ withdrawal on diaphragmatic fiber tension generation. J Appl Physiol 64:15–19Google Scholar
  6. 6.
    Macklem PT, Roussos C (1977) Respiratory muscle fatigue: a cause of respiratory failure? Clin Sci Mol Med 53:419–422PubMedGoogle Scholar
  7. 7.
    Robertson CM Jr, Foster GH, Johson RL Jr (1977) The relationship of respiratory failure to the oxygen consumption of, lactate production by, and distribution of blood flow among respiratory muscle during increasing inspiratory resistance. J Clin Invest 59:31–42PubMedCrossRefGoogle Scholar
  8. 8.
    Rochester DF, Pradel-Guena F (1973) Measurement of diaphragmatic blood flow in dogs from xenon 133 clearance. J Appl Physiol 34:68–74PubMedGoogle Scholar
  9. 9.
    Adachi H, Strauss W, Ochi H, Wagner HN Jr (1976) The effects of hypoxia on the regional distribution of cardiac output in the dog. Cir Res 39:314–319Google Scholar
  10. 10.
    Mortimer J J, Magnusson R, Peterson I (1970) Conduction velocity in ischemic muscle: effect on EMG frequency spectrum. Am J Physiol 219:1324–1329PubMedGoogle Scholar
  11. 11.
    Moran N (1972) The effects of cardiac glycosides on mechanical properties of heart muscle. In: Marks BM, Weisler AM (eds) Basic and Clinical Pharmacology of Digitalis. Springfield, Illinois, Thomas, pp. 94–117Google Scholar
  12. 12.
    Smith TW, Maber F (1973) Digitalis. N Engl J Med 289:945–952PubMedCrossRefGoogle Scholar
  13. 13.
    Katz AM, Repke DI (1973) Calcium - membrane interaction in the myocardium: Effects of ouabain, epinephrine and 3’5’-cyclic adenosine monophosphate. Am J Cardiol 31:193–201PubMedCrossRefGoogle Scholar
  14. 14.
    Aubier M, Viires N, Murciano D, et al (1986) Effects of digoxin on diaphragmatic strength generation. J Appl Physiol 61:1767–1774PubMedGoogle Scholar
  15. 15.
    Kikuchi Y, Hid W, Shindoh C, et al (1987) Effects of digitalis on the diaphragm in anesthetized dogs. J Appl Physiol 63:277–284PubMedGoogle Scholar
  16. 16.
    Aubier M, Viires N, Murciano D, Seta JP, Pariente R (1986) Effects of digoxin on diaphragmatic strength generation. J Appl Physiol 61:1767–1774PubMedGoogle Scholar
  17. 17.
    Aubier M, Murciano D, Viires N, et al (1987) Effects of digoxin on diaphragmatic strength generation in patients with chronic obstructive pulmonary disease during acute respiratory failure. Am Rev Respir Dis 135:544–548PubMedGoogle Scholar
  18. 18.
    Aubier M, Murciano D, Viires N, Lecoguic Y, Pariente R (1985) Diaphragmatic contractility enhanced by aminophylline: role of extracellular calcium. J App Physiol 54:460–464Google Scholar
  19. 19.
    Potreau D, Raymond G (1979) Calcium-dependent electrical activity and contraction of voltage clamped frog single muscle fibers. J Physiol (London) 307:9–22Google Scholar
  20. 20.
    Prosdocini M, Bianchi CP (1981) Effect of adenosine on oxygen uptake and electrolyte content of frog muscle. J Pharmacol Exp Ther 218:87–96Google Scholar
  21. 21.
    Sawynok J, Thamandas KH (1976) Inhibition of acetylcholine release from cholinergic nerves by adenosine, adenine nucleotides and morphine: Antagonism by theophylline. J Pharmacol Exp Ther 197:379–390Google Scholar
  22. 22.
    Jones DA, Howell S, Roussos C, et al (1982) Low frequency fatigue in isolated skeletal muscles and the effects of methylxanthines. Clin Sci 63:161–167PubMedGoogle Scholar
  23. 23.
    Kentera D, Varagic VM (1975) The effects of cyclic N-2–0 dibutyryl-adenosine 3’5’-monophosphate, adrenaline and mainophylline on the isometric contractility of the isolated diaphragm of the rat. Br J Pharmacol 54:375–381PubMedGoogle Scholar
  24. 24.
    Viires N, Aubier M, Murciano D, Marty C, Pariente R (1986) Effects of theophylline on isolated diaphragmatic fibers: a model for pharmacological studies on diaphragmatic contractility. Am Rev Respir Dis 133:1060–1064PubMedGoogle Scholar
  25. 25.
    Aubier M, De Troyer A, Sampson M, Macklem PT, Roussos C (1981) Aminophylline improves diaphragmatic contractility. N Engl J Med 305:249–252PubMedCrossRefGoogle Scholar
  26. 26.
    Eaton M, Green BA, Church TR, Mc Gowan T, Nievoehner DF (1980) Efficacy of theophylline in “irreversible” airflow obstruction. Ann Intern Med 92:758–761PubMedGoogle Scholar
  27. 27.
    Nietrzeba RM, Elliott GG, Adams TD, Yeh MP, Yanowitz FG (1984) Effects of aminophylline upon the exercise performance of patients with stable respiration. Eur J Resp Dis 20:361–367Google Scholar
  28. 28.
    Malher DA, Matthay RA, Snyder PE, Wells CK, Loke J (1985) Sustained-release theophylline reduces dyspnea in non-reversible obstructive airway disease. Am Rev Respir Dis 131:22–25Google Scholar
  29. 29.
    Murciano D, Aubier M, Viires N, Mai M, Pariente R (1987) Effects of theophylline and enprophylline on diaphragmatic contractility. J Appl Physiol 63:51–57PubMedGoogle Scholar
  30. 30.
    Murciano D, Auclair MH, Pariente R, Aubier M (1989) A randomized controlled trial of theophylline in patients with severe chronic obstructive pulmonary disease. N Engl J Med 320:1521–1525PubMedCrossRefGoogle Scholar
  31. 31.
    Aubier M, Murciano D, Menu Y, Boczkowski J, Mai H, Pariente R (1989) Dopamine effects on diaphragmatic strength during acute respiratory failure in chronic obstructive pulmonary disease. Ann Intern Med 110:107–123Google Scholar
  32. 32.
    Fitts RH, Holloszy O (1976) Lactate and contractile force in frog muscle during development of fatigue and recovery. Am J Physiol 231:430–433PubMedGoogle Scholar
  33. 33.
    Schader JH, Juan G, Hawell S, Fitzgerald R, Roussos C (1985) Arterial C02 partial pressure effects diaphragmatic function. J Appl Physiol 58:823–829Google Scholar
  34. 34.
    Juan G, Calverey P, Talamo C, Schnader JY, Roussos C (1984) Effect of carbon dioxide on diaphragmatic function in human beings. N Engl J Med 310:74–79CrossRefGoogle Scholar
  35. 35.
    Aubier M, Murciano D, Lecoguic Y, et al (1985) Effect of hypophosphatemia on diaphragmatic contractility in patients with acute respiratory failure. N Engl J Med 313:420–424PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • M. Aubier

There are no affiliations available

Personalised recommendations