Rebuttal from Alan R. Schwartz and Philip L. Smith

摘要

Butler et al. present an interesting alternative to the Starling resistor model to account for the phenomenon of negative effort dependence (Butler et al. 2013). This phenomenon is characterized by a decrease in flow with increasing inspiratory effort, which can occur to a variable degree in sleeping individuals. Negative effort dependence is a feature commonly observed in pressure-flow relationships in collapsible conduits, whether they be biological or otherwise, and is illustrated in the classical descriptions of flow limitation to which Butler and co-workers referred.