The ventilatory recruitment threshold for carbon dioxide

The American Review of Respiratory Disease
G C PrechterR D Hubmayr

Abstract

We report our initial experience with a technique with which the chemoresponsiveness of the respiratory controller can be characterized in terms of an inspiratory on-switch threshold to CO2. After suppression of phasic respiratory muscle activity by mechanical ventilation, a CO2 recruitment threshold (PCO2RT) was defined as the lowest alveolar CO2 tension at which CO2 supplementation to inspired gas caused a reappearance of inspiratory efforts. Because PCO2RT can be determined in the absence of a mechanical load on the ventilatory pump, respiratory system mechanics and inspiratory muscle function should not influence the measurement itself. Thus, this technique may be helpful to study ventilatory requirements and load responses in critically ill patients with respiratory failure. We have shown that inspiratory muscle recruitment can be equally well-inferred from changes in the airway pressure and flow tracings during mechanical ventilation, from the pattern of chest wall displacement, and from the integrated diaphragm electromyogram. Within a subject, PCO2RT is a reproducible measurement that is not influenced by ventilator settings and end-expiratory lung volume, provided that phasic respiratory muscle has been suppressed prio...Continue Reading

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Citations

Aug 1, 1995·Respiration Physiology·D R CorfieldA Guz
Jan 1, 1996·Respiration Physiology·R B BanzettS A Shea
Dec 1, 1995·Respiration Physiology·C A RobertsA Guz
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May 24, 2001·American Journal of Respiratory and Critical Care Medicine·M Younes
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Jan 10, 2002·American Journal of Respiratory and Critical Care Medicine·Andrew P BinksRichard M Schwartzstein
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Apr 26, 2003·American Journal of Respiratory and Critical Care Medicine·Stephen CorneMagdy Younes
Feb 8, 2005·Critical Care : the Official Journal of the Critical Care Forum·George PrinianakisDimitris Georgopoulos
Nov 19, 2008·Critical Care : the Official Journal of the Critical Care Forum·Polychronis MalliotakisDimitris Georgopoulos
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Sep 6, 2003·American Journal of Physiology. Heart and Circulatory Physiology·H E CooperM J Parkes
Dec 8, 1998·Journal of Applied Physiology·B FaurouxF Lofaso

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