Hypoxia and the "reaction theory" of central respiratory chemosensitivity.

In peripherally chemodenervated and vagotomized cats and rabbits, either spontaneously breathing or artificially ventilated, we studied the reaction of the respiratory control system to changes in the extracellular fluid (ECF) pH at the ventral surface of the medulla oblongata. The brainstem ECF-pH was varied either by alternating periods of hypoxia and hyperoxia or by intravenous infusion of lactic acid to achieve endogenous or exogenous lactacidosis, respectively. Additionally, the arterial PCO2 was changed by varying the inspiratory CO2-fraction or the respirator's pumping rate. When pulmonary ventilation or central respiratory drive (in terms of phrenic nerve activity) was related to brainstem ECF-pH, no unique function resulted for respiratory (CO2-induced) and metabolic (lactic acid induced) acid-base changes, thus contradicting the "reaction theory" for central respiratory chemosensitivity. Under steady state conditions, there was no ventilatory reaction to endogenous or exogenous metabolic brainstem acidosis at all. However, the apneic threshold was shifted towards the acid range, although the sensitivity of the respiratory system to CO2 remained nearly unchanged, no matter whether CO2 was inhaled or increased by acetazolamide. This points to a dominating role of CO2 or at least carbonic acid over fixed acids for the central chemosensitive control of pulmonary ventilation.