Glossopharyngeal breathing (GPB, glossopharyngeal insufflation, buccal pumping, or frog breathing) is a means of pistoning air into the lungs to volumes greater than can be achieved by the person's breathing muscles (greater than maximum inspiratory capacity). The technique involves the use of the glottis to add to an inspiratory effort by gulping boluses of air into the lungs. It can be beneficial for individuals with weak inspiratory muscles and no ability to breathe normally on their own. The technique was first observed by physicians in the late 1940s in polio patients at Rancho Los Amigos Hospital, in Los Angeles, by Dr. Clarence W. Dail and first described by Dail in 1951 in the journal California Medicine. Both inspiratory and, indirectly, expiratory muscle function can be assisted by GPB. GPB can provide an individual with weak inspiratory muscles and no vital capacity or ventilator-free breathing tolerance with normal alveolar ventilation and perfect safety when not using a ventilator or in the event of sudden ventilator failure day or night. The technique involves the use of the glottis to add to an inspiratory effort by projecting (gulping) boluses of air into the lungs. The glottis closes with each "gulp". One breath usually consists of 6 to 9 gulps of 40 to 200 ml each. During the training period the efficiency of GPB can be monitored by spirometrically measuring the milliliters of air per gulp, gulps per breath, and breaths per minute. A training manual and numerous videos are available, the most detailed of which was produced in 1999. For those who can not master GPB it is often because of inability of the soft palate to seal off the nose. Although severe oropharyngeal muscle weakness can limit the usefulness of GPB, researchers have cited Duchenne muscular dystrophy ventilator users who were very successful using it. Approximately 60% of ventilator users with no autonomous ability to breathe and good bulbar muscle function can use GPB for autonomous breathing from a span of minutes up to all day. Patients with no vital capacity have awoken from sleep using GPB to discover that their ventilators were no longer functioning. Some have spontaneously come out of anesthesia frog breathing and others out of grand mal convulsions surprisingly without being cyanotic.
Freediving
Lung packing or buccal pumping is a technique used in deep freediving for inflating the lungs beyond their normal isobaric total capacity, which is used to delay the compression of the lungs at by hydrostatic pressure, allowing a greater depth to be reached, and provide a slightly larger reserve of oxygen for the dive. After full normal inspiration, the diver fills the mouth with air, with the glottis closed, then opens the glottis and forces the air from the mouth into the lung, then closes the glottis to hold in the air. This is repeated several times. Lung packing can increase the volume of air in the lungs by up to 50% of vital capacity. The pressure induced will reduce the volume of blood in the chest, which will increase the space available for air. The gas in the lungs is also compressed. Pressures of about 75 millimetres of mercury (100 mbar) have been reported.
See also Paul Alexander – American polio survivor and writer who used the technique (1946–2024) Buccal pumping Freediving Physiology of Freediving
Footnotes
