Fig 1. Overview of surgical preparation, EMG placement, and cough measures.

A) A diagram illustrates EMG and tracheostomy setup. Parasternals and internal obliques were recorded bilaterally. For experiments without added CO2, the end-tidal CO2 (ETCO2) line was connected to the Air/CO2 port. Cough was mechanically stimulated with a flexible plastic cannula in the thoracic trachea. EMG placements were confirmed visually, corresponding to their activity during control cough and swallow trials. B) A representative cough trial shows cough phase duration and amplitude measurements. The top pairs of traces are integrated and raw electromyograms (EMGs), respectively, of respiratory muscles: the inspiratory diaphragm (DIA) and expiratory internal obliques (IO). Their pattern of activation generates an intrathoracic pressure that was measured by an esophageal balloon (ESPR). An end-tidal CO2 (ETCO2) recording provided additional information about respiratory state. Cardiovascular data were measured with a blood pressure (BP) transducer and electrocardiography (not shown).