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Long-term facilitation of ventilation following acute continuous hypoxia in awake humans during sustained hypercapnia

机译:在持续高碳酸血症期间清醒的人持续急性缺氧后长期通气

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摘要

In awake humans, long-term facilitation of ventilation (vLTF) following acute intermittent hypoxia (AIH) is only expressed if CO2 is maintained above normocapnic levels. vLTF has not been reported following acute continuous hypoxia (ACH) and it is not known whether this might be unmasked by elevated CO2. Twelve healthy participants completed three trials. In all trials end-tidal pressure of CO2 was elevated 4–5 mmHg above normocapnic levels. During Trial 1 (AIH) participants were exposed to eight 4 min episodes of hypoxia. During Trial 2 (ACH) participants were exposed to continuous hypoxia for 32 min. In Trial 3 (Control) participants were exposed to euoxia throughout. To assess the contribution of the carotid body (CB) in observed ventilatory responses, CB afferent discharge before and after each trial was transiently inhibited with hyperoxia. Minute ventilation () increased following all trials, but was significantly greater in Trials 1 and 2 when compared with Trial 3 (Trial 1: 4.96 ± 0.87, Trial 2: 5.07 ± 0.7, Trial 3: 2.55 ± 0.98 l min−1, P < 0.05). Hyperoxia attenuated to a similar extent in baseline and recovery in all trials (Trial 1: 3.0 ± 0.57 vs. 3.27 ± 0.68, Trial 2: 1.97 ± 0.62 vs. 2.56 ± 0.62, Trial 3: 2.23 ± 0.49 vs. 2.15 ± 0.55 l min−1, P > 0.05). Data are means ± SEM. In awake humans with elevated CO2, ACH evokes a sustained increase in ventilation that is comparable to that evoked by AIH. However, a gradual positive drift in ventilation in response to elevated CO2 accounts for approximately half of this apparent vLTF. Additionally, our data support the view that the CB is not directly involved in maintaining vLTF.
机译:在清醒的人类中,只有在CO2维持在正常碳酸水平以上的情况下,才能表达急性间歇性缺氧(AIH)后的长期通气(vLTF)。急性持续性缺氧(ACH)后尚未报道vLTF,尚不清楚是否可以通过升高的CO2来掩盖vLTF。十二名健康参与者完成了三项试验。在所有试验中,二氧化碳的潮气末压都比正常碳酸水平高出4-5 mmHg。在试验1(AIH)中,参与者经历了8次4分钟的缺氧发作。在试验2(ACH)中,参与者暴露于持续性缺氧32分钟。在试验3(对照)中,参与者始终暴露于神经性缺氧症。为了评估颈动脉体(CB)在观察到的通气反应中的作用,每次试验前后的CB传入放电均被高氧短暂抑制。在所有试验中,分钟通气量()增加,但与试验3相比,试验1和2中的通气量显着增加(试验1:4.96±0.87,试验2:5.07±0.7,试验3:2.55±0.98 l分钟<- 1 ,P <0.05)。高氧血症在所有试验中的基线和恢复程度均有相似程度的衰减(试验1:3.0±0.57 vs.3.27±0.68,试验2:1.97±0.62 vs.2.56±0.62,试验3:2.23±0.49 vs.2.15±0.55 l min -1 ,P> 0.05)。数据是平均值±SEM。在CO2升高的清醒人群中,ACH引起的通气持续增加,与AIH引起的通气增加相当。但是,随着二氧化碳浓度的升高,通风的逐渐正向漂移约占该表观vLTF的一半。此外,我们的数据支持CB不直接参与维护vLTF的观点。

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