Patterns of Ventilatory Response to Carbon Dioxide during Recovery from Severe Asthma

Rebuck, A. S.; Read, John

doi:10.1042/cs0410013

Cited by 94 publications

(34 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, long-term hypoxemia-induced DVH has been observed in residents living at high altitude (34,35) and in patients with congenital cyanotic heart disease (8). However, available data showed that some asthmatic patients with DVH exhibited hypoxemia (14,15,26,31), whereas others did not (21,32). Although DVH is generally observed in asthmatic individuals, the results concerning the ventilatory response to hypercapnia were controversial.…”

mentioning

confidence: 87%

“…We found that Ova-exposure caused DVH in guinea pigs without significant changes in Pa O 2 and Pa CO 2 during eupneic breathing, demonstrating that DVH is not the result of preexisting hypoxemia. In fact, hypoxemia is not uniformly observed in asthmatic individuals (3,14,15,21,26,31,32) and not necessarily related to the degree of asthmatic severity (21). In addition, Ova treatment in guinea pigs failed to change body weight, baseline cardiorespiratory activities, baseline total pulmonary resistance, and dynamic lung compli- ance (41).…”

Section: Presence Of Dvh In Ova Guinea Pigs Provides a Useful Animal mentioning

confidence: 99%

“…In clinical studies, the data of the ventilatory responses to hypercapnia in asthmatic individuals are controversial. Some results from the asthmatic individuals showed a lack of significant change in the ventilatory response to hypercapnia (10,32,38), whereas a decreased (14,15,27) or increased hypercapnic ventilation (20,28,37) was also documented. These clinically observed discrepancies in the hypercapnic ventilation may be the results of varied baseline blood gases in these patients.…”

Section: Dvh In Ova Guinea Pigs Involves At Least Partially the Supmentioning

confidence: 99%

“…However, the pathophysiology involved in the DVH is not fully understood because of the limitations on experimental study in humans. For example, the multiple factors, such as differences in heredity (14,19), severity of sickness (21), and arterial blood gases (10,32,38), have complicated and hindered the study of the pathogenic mechanisms of DVH. Long-term hypoxia-induced DVH has been observed in highaltitude residents (34,35) and in patients with congenital cyanotic heart disease (8).…”

Section: Presence Of Dvh In Ova Guinea Pigs Provides a Useful Animal mentioning

confidence: 99%

“…Although DVH is generally observed in asthmatic individuals, the results concerning the ventilatory response to hypercapnia were controversial. A lack of significant change (10,32,38), decrease (14,15,27), or increase in the ventilatory response to hypercapnia (20,28,37) has been observed in asthmatic patients. This controversy coupled with other possible factors involved with DVH, such as the heredity (14,19), severity of sickness (21), and the different number of previous respiratory failures (38), complicated the study of mechanisms underlying DVH.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Ovalbumin sensitization alters the ventilatory responses to chemical challenges in guinea pigs

Zhuang²,

Zhou³

et al. 2005

Journal of Applied Physiology

View full text Add to dashboard Cite

tients with chronic bronchial asthma show a depressed ventilatory response to hypoxia (DVH), but the underlying mechanism remains unclear. We tested whether DVH existed in ovalbumin (Ova)-treated guinea pigs, an established animal model of asthma. Twelve guinea pigs were exposed to Ova (1% in saline) or saline aerosol (control) for 5 min, 5 days/wk, for 2 wk. After completing aerosol exposure, the animals were anesthetized and exposed to systemic hypoxia. Ova treatment had no effects on animal body weight, baseline cardiorespiratory variables, or arterial blood O 2 and CO2 tensions, but it attenuated the ventilatory response to hypoxia (10 breaths of pure N 2) by 65% (P Ͻ 0.05). When the animals were subjected to intracarotid injections of sodium cyanide (20 g) and doxapram (2 mg) to selectively stimulate carotid chemoreceptors, the ventilatory responses were reduced by 50% (P Ͻ 0.05) and 74% (P Ͻ 0.05), respectively. In contrast, Ova exposure failed to affect the ventilatory response to CO 2 (7% CO2-21% O2-balance N2 for 5 min; P Ͼ 0.05). Furthermore, the apneic response evoked by stimulating bronchopulmonary C fibers (PCFs) with right atrial injection of capsaicin (5 g) was markedly increased in the Ova-sensitized group (5.02 Ϯ 1.56 s), compared with the control group (1.82 Ϯ 0.45 s; P Ͻ 0.05). These results suggest that Ova sensitization induces a DVH in guinea pigs, which probably results from an attenuation of the carotid chemoreceptor-mediated ventilatory excitation and an enhancement of the PCF-mediated ventilatory inhibition. carotid body; bronchopulmonary C fibers; hypoxia; capsaicin; inflammation RESPIRATORY FAILURE FROM ASTHMA is a common clinical symptom and a primary cause of high mortality. A study through a period of 7 yr indicated that 68% of asthmatic patients had two or more episodes of respiratory failure that led to an ϳ10% death rate (30). Ventilatory arrest in the near-fatal nature of the exacerbations is dominant compared with cardiac arrest (26). It is generally recognized that patients with chronic bronchial asthma have a depressed ventilatory response to hypoxia (DVH) that may contribute to the respiratory failure (4, 11, 14 -16, 21, 33, 38), although an absence (27) of DVH or an increase of ventilatory response to hypoxia (20) was also reported. Hudgel and Weil (14,15) first reported a severe DVH in asthmatic individuals in 1974. Subsequent studies confirmed this observation and further indicated that the amplitude of minute ventilation (V E) in response to progressive isocapnic hypoxia was significantly attenuated in both young and adult patients compared with age-matched normal subjects (4,11,16,21,33,38). A severely diminished hypoxic perception was also found in asthmatic patients; a typical example is that the patients who had asthma displayed cyanosis but had no dyspnea at all (21). This blunted hypoxic perception could impair the behavioral control of breathing and worsen hypoxemia by reducing ventilatory augmentation. To date, the pathophysiological mechanisms underlying DVH i...

show abstract

mentioning

confidence: 87%

Section: Presence Of Dvh In Ova Guinea Pigs Provides a Useful Animal mentioning

confidence: 99%

Section: Dvh In Ova Guinea Pigs Involves At Least Partially the Supmentioning

confidence: 99%

Section: Presence Of Dvh In Ova Guinea Pigs Provides a Useful Animal mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Ovalbumin sensitization alters the ventilatory responses to chemical challenges in guinea pigs

Zhuang²,

Zhou³

et al. 2005

Journal of Applied Physiology

View full text Add to dashboard Cite

show abstract

Ventilatory Failure, Ventilator Support, and Ventilator Weaning

Tobin

Laghi

Jubran

2012

Comprehensive Physiology

View full text Add to dashboard Cite

The development of acute ventilatory failure represents an inability of the respiratory control system to maintain a level of respiratory motor output to cope with the metabolic demands of the body. The level of respiratory motor output is also the main determinant of the degree of respiratory distress experienced by such patients. As ventilatory failure progresses and patient distress increases, mechanical ventilation is instituted to help the respiratory muscles cope with the heightened workload. While a patient is connected to a ventilator, a physician's ability to align the rhythm of the machine with the rhythm of the patient's respiratory centers becomes the primary determinant of the level of rest accorded to the respiratory muscles. Problems of alignment are manifested as failure to trigger, double triggering, an inflationary gas-flow that fails to match inspiratory demands, and an inflation phase that persists after a patient's respiratory centers have switched to expiration. With recovery from disorders that precipitated the initial bout of acute ventilatory failure, attempts are made to discontinue the ventilator (weaning). About 20% of weaning attempts fail, ultimately, because the respiratory controller is unable to sustain ventilation and this failure is signaled by development of rapid shallow breathing. Substantial advances in the medical management of acute ventilatory failure that requires ventilator assistance are most likely to result from research yielding novel insights into the operation of the respiratory control system.

show abstract

Control of Breathing in Diseases of the Respiratory Tract and Lungs

Rěbuck

Slutsky

1986

Comprehensive Physiology

View full text Add to dashboard Cite

Patterns of Ventilatory Response to Carbon Dioxide during Recovery from Severe Asthma

Cited by 94 publications

References 14 publications

Ovalbumin sensitization alters the ventilatory responses to chemical challenges in guinea pigs

Ovalbumin sensitization alters the ventilatory responses to chemical challenges in guinea pigs

Ventilatory Failure, Ventilator Support, and Ventilator Weaning

Control of Breathing in Diseases of the Respiratory Tract and Lungs

Contact Info

Product

Resources

About