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等碳酸血症性低氧对呼吸变异活动的影响。

Effect of isocapnic hypoxia on variational activity of breathing.

作者信息

Jubran A, Tobin M J

机构信息

Division of Pulmonary and Critical Care Medicine, Edward Hines Jr., Veterans Affairs Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, Illinois, USA.

出版信息

Am J Respir Crit Care Med. 2000 Oct;162(4 Pt 1):1202-9. doi: 10.1164/ajrccm.162.4.9907003.

Abstract

In the presence of either hypocapnia or sleep, hypoxia has been shown to induce periodic breathing and increase the total variational activity of breath components. It is not known whether hypoxia induces alterations in breathing variability during wakefulness and in the absence of hypocapnia. To address this issue, we studied nonobtrusively 14 healthy awake subjects before and during the delivery of a hypoxic gas mixture via a plastic hood; the subjects' oxygen saturation decreased from 98 to 79% and end-tidal carbon dioxide tension was kept constant. Compared with air, isocapnic hypoxia increased the gross variability of minute ventilation (V I), tidal volume (VT), inspiratory time (TI), and expiratory time (TE) (all p < 0.004). Isocapnic hypoxia decreased the autocorrelation coefficient at a lag of one breath for TE (p < 0. 008) and V I (p = 0.07), the number of consecutive breath lags having significant autocorrelation coefficients for TE (p = 0.03), and the cycle time of oscillations in V I (p = 0.03). When partitioned, the increase in total variational activity during isocapnic hypoxia was found to result from increases in the random fractions of V I, VT, TI, and TE (all p < 0.05), and the oscillatory fractions of V I, VT, and TE (all p < 0.03). In conclusion, hypoxia induced hidden oscillations in V I, VT, and TE despite wakefulness and an isocapnic state, suggesting that neural responses may have a more important role in the genesis of hypoxia-induced oscillations than previously reported.

摘要

在存在低碳酸血症或睡眠的情况下,低氧已被证明可诱发周期性呼吸并增加呼吸成分的总变异性活动。尚不清楚在清醒且不存在低碳酸血症的情况下,低氧是否会引起呼吸变异性的改变。为了解决这个问题,我们通过塑料面罩对14名健康清醒受试者在输送低氧混合气体之前和期间进行了非侵入性研究;受试者的氧饱和度从98%降至79%,呼气末二氧化碳分压保持恒定。与空气相比,等碳酸血症性低氧增加了分钟通气量(VI)、潮气量(VT)、吸气时间(TI)和呼气时间(TE)的总体变异性(所有p<0.004)。等碳酸血症性低氧降低了TE(p<0.008)和VI(p = 0.07)在一个呼吸滞后时的自相关系数、TE具有显著自相关系数的连续呼吸滞后次数(p = 0.03)以及VI振荡的周期时间(p = 0.03)。当进行划分时,发现等碳酸血症性低氧期间总变异性活动的增加是由于VI、VT、TI和TE的随机部分增加(所有p<0.05)以及VI、VT和TE的振荡部分增加(所有p<0.03)所致。总之,尽管处于清醒和等碳酸血症状态,低氧仍在VI、VT和TE中诱发了隐藏振荡,这表明神经反应在低氧诱导振荡的发生中可能比先前报道的具有更重要的作用。

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