Reversal of functional disorders by aspiration, expiration, and cough reflexes and their voluntary counterparts

Abstract

Agonal gasping provoked by asphyxia can save ~15% of mammals even from untreated ventricular fibrillation (VF), but it fails to revive infants with sudden infant death syndrome (SIDS). Our systematic study of airway reflexes in cats and other animals indicated that in addition to cough, there are two distinct airway reflexes that may contribute to auto-resuscitation. Gasp- and sniff-like spasmodic inspirations (SIs) can be elicited by nasopharyngeal stimulation, strongly activating the brainstem generator for inspiration, which is also involved in the control of gasping. This “aspiration reflex” (AspR) is characterized by SI without subsequent active expiration and can be elicited during agonal gasping, caused by brainstem trans-sections in cats. Stimulation of the larynx can activate the generator for expiration to evoke the expiration reflex (ExpR), manifesting with prompt expiration without preceding inspiration. Stimulation of the oropharynx and lower airways provokes the cough reflex (CR) which results from activating of both generators. The powerful potential of the AspR resembling auto-resuscitation by gasping can influence the control mechanisms of vital functions, mediating reversal of various functional disorders. The AspR in cats interrupted hypoxic apnea, laryngo- and bronchospasm, apneusis and even transient asphyxic coma, and can normalize various hypo- and hyper-functional disorders. Introduction of a nasogastric catheter evoked similar SIs in premature infants and interrupted hiccough attacks in adults. Coughing on demand can prevent anaphylactic shock and resuscitate the pertinent subject. Sniff representing nasal inspiratory pressure and maximal inspiratory and expiratory pressures (MIP and MEP) are voluntary counterparts of airway reflexes, and are useful for diagnosis and therapy of various cardio-respiratory and neuromuscular disorders.

Physical Disorders are Associated with Health Risk Behaviors in Chinese Adolescents: A Latent Class Analysis

“…Interestingly, compared with the moderate-risk class 1, the risk of cough is higher in the moderate-risk class 2, we speculated that it could be the consequence of unintentional injuries, as studies have shown that unintentional injuries (such as asphyxia and drowning, etc.) can also cause cough [58,59]. Taken together, compared to low-risk students that had less HRBs, students with different HRBs showed significantly higher occurrence of various physical disorders, and the most significant correlation was observed in the high-risk students that had many more HRBs (Table 3).…”

“…These findings indicated that different HRBs had different effects on different physical disorders of adolescents. We speculate that the moderate-risk class 2 increased the incidence of cough due to the existence of unintentional injuries [58,59], and drinking and smoking in the moderate-risk class 1 often cause vomiting and fever [16,17].…”

Resuscitation and auto resuscitation by airway reflexes in animals

“…In addition to gasp- and sniff-like aspiration reflex elicited from the nasopharynx, sniffing from the upper part of nasal cavity, expiration reflex from the larynx, the cough reflex from the trachea-bronchial region and sneezing from the nasal mucosa. Modified from our earlier publications [ 22 , 31 , 40 ].…”

“…Such approved similarity of gasp-like AspR in cats and other animals, with the gasping in infants suggests also similar resuscitation potential for AspR in cats and other animals, than gasping in human infants. It allows also a hypothesis that normalization or resuscitation and even autoresuscitation potential of airway reflexes may exist in humans, which was supported by reversal of various functional disorders using airway reflexes in men [ 40 ].…”

“…The cough reflex induced by stimulation of various airway receptors, held as a “watchdog of the lung” consists of 3 phases. After the initial deep inspiration (DI) there is a rapid compressive phase with glottal closure, followed by strong expulsion of the enlarged lung volume [ 21 , 22 , 31 , 40 , 41 ]. The gradually increasing lung volume stimulates the SARs, and via the Hering- Breuer inflation reflex (HBIR) tends to inhibite adequately the progressive inspiration similarly as in eupnoea.…”