"Won't breathe" vs "can't breathe". Detection of depressed ventilatory drive in patients with obstructive pulmonary disease. 1983

P J Fahey, and R W Hyde

Impaired pulmonary mechanics or depression of the respiratory centers can limit the ventilatory response to inhaled carbon dioxide in patients with chronic obstructive pulmonary disease (COPD). We devised a method able to detect depressed neurogenic and chemical ventilatory drive during expiratory airflow obstruction. In 14 normal subjects, we impeded expiratory airflow while measuring the resultant decline in maximum voluntary ventilation (MVV) and the ventilatory response to rebreathing 7 percent CO2 (delta V/delta PCO2). The MVV and delta V/delta PCO2 fell proportionately and were closely correlated (r = 0.88). The lower limit for delta V/delta PCO2 during airway obstruction equalled 1.2 L/min/mm Hg X (observed MVV divided by predicted MVV). Nine patients with COPD and normal arterial carbon dioxide tension (PaCO2) all had normal values for delta V/delta PCO2 corrected for MVV; however, nine of 12 patients with COPD and elevated PaCO2 and bicarbonate levels had depressed values for delta V/delta PCO2. These data indicate that neurogenic and chemical depression to ventilation can be detected in patients with mechanical obstruction to expiratory airflow if delta V/delta PCO2 is corrected for changes in MVV.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D008173 Lung Diseases, Obstructive Any disorder marked by obstruction of conducting airways of the lung. AIRWAY OBSTRUCTION may be acute, chronic, intermittent, or persistent. Obstructive Lung Diseases,Obstructive Pulmonary Diseases,Lung Disease, Obstructive,Obstructive Lung Disease,Obstructive Pulmonary Disease,Pulmonary Disease, Obstructive,Pulmonary Diseases, Obstructive
D008297 Male Males
D008451 Maximal Voluntary Ventilation Measure of the maximum amount of air that can be breathed in and blown out over a sustained interval such as 15 or 20 seconds. Common abbreviations are MVV and MBC. Maximal Breathing Capacity,MVV (Ventilation),Breathing Capacities, Maximal,Breathing Capacity, Maximal,Capacities, Maximal Breathing,Capacity, Maximal Breathing,Maximal Breathing Capacities,Maximal Voluntary Ventilations,Ventilation, Maximal Voluntary,Ventilations, Maximal Voluntary,Voluntary Ventilation, Maximal,Voluntary Ventilations, Maximal
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D012125 Respiratory Center Part of the brain located in the MEDULLA OBLONGATA and PONS. It receives neural, chemical and hormonal signals, and controls the rate and depth of respiratory movements of the DIAPHRAGM and other respiratory muscles. Center, Respiratory,Centers, Respiratory,Respiratory Centers
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D004328 Drive A state of internal activity of an organism that is a necessary condition before a given stimulus will elicit a class of responses; e.g., a certain level of hunger (drive) must be present before food will elicit an eating response. Drives
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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