Chest
Clinical InvestigationsVENTILATORSEffects of Hypocapnic Hyperventilation on the Response to Hypoxia in Normal Subjects Receiving Intermittent Positive-Pressure Ventilation
Section snippets
The Concept of VRH During nIPPV
In a spontaneously breathing subject, exposure to hypoxia results in a VRH defined by an increase in e due to an increase in Vt and a decrease in the total duration of each breath (ie, an increase in respiratory frequency). The situation is different in a subject receiving passive mechanical ventilation with a noninvasive mode (ie, with his carbon dioxide level below the apneic threshold resulting in a silent EMGdi). When using volumetric ventilators in the controlled mode, both
Results
Forty-two N2 runs were performed: 12 N2 runs in subject 1, 7 N2 runs in subject 2, 11 N2 runs in subject 3, and 12 N2 runs in subject 4 (Table 1). Five N2 runs were discarded from the study because of instability in sleep and/or ventilation at the beginning of the run. Thirty-seven N2 runs were retained for analysis: 7 N2 runs during wakefulness, 15 N2 runs during stage 2 nonrapid eye movement (NREM) sleep, 3 N2 runs during stage 3 NREM sleep, 8 N2 runs during stage 4 NREM sleep, and 4 N2 runs
Discussion
It is well known that hypocapnia can arrest basal ventilation. Below this apneic threshold, the respiratory muscles are inhibited and spontaneous ventilation ceases. However, hypoxia, which is a potent ventilatory stimulus, is able to reactivate the respiratory muscles that are inhibited by hypocapnia. To the best of our knowledge, this study, which was performed in normal subjects receiving passive hyperventilation with nIPPV, is the first to prove that the ventilatory response to severe
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2013, Respiratory Physiology and NeurobiologyCitation Excerpt :For this hypothesis to be correct, it is necessary that the peripheral chemoreflex responds to hypoxia in the presence of hypocapnia induced by hyperventilation during wakefulness. However, previous studies in humans suggest that this may not be the case (Duffin, 2007; Jounieaux et al., 2002; Mohan and Duffin, 1997). If the peripheral chemoreflex does not respond to hypoxia in the presence of hypocapnia, it is likely that apnea duration would be prolonged, despite enhancement of the peripheral chemoreflex, because of the duration of time required for carbon dioxide to slowly build to the point that the apneic threshold is exceeded.
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Partly supported by grants 9.4547.93 and 3.4533.98 from the Belgian Fonds de la Recherche Scientifique Médicale.