Medical Service, John D. Dingell Veterans Affairs Medical Center, Detroit, MI 48201, USA.
J Appl Physiol (1985). 2010 Nov;109(5):1378-83. doi: 10.1152/japplphysiol.00453.2010. Epub 2010 Aug 19.
The present study was designed to determine whether hyperoxia would lower the hypocapnic apneic threshold (AT) during non-rapid eye movement (NREM) sleep. Nasal noninvasive mechanical ventilation was used to induce hypocapnia and subsequent central apnea in healthy subjects during stable NREM sleep. Mechanical ventilation trials were conducted under normoxic (room air) and hyperoxic conditions (inspired PO(2) > 250 Torr) in a random order. The CO(2) reserve was defined as the minimal change in end-tidal PCO(2) (PET(CO(2))) between eupnea and hypocapnic central apnea. The PET(CO(2)) of the apnea closest to eupnea was designated as the AT. The hypocapnic ventilatory response was calculated as the change in ventilation below eupnea for a given change in PET(CO(2)). In nine participants, compared with room air, exposure to hyperoxia was associated with a significant decrease in eupneic PET(CO(2)) (37.5 ± 0.6 vs. 41.1 ± 0.6 Torr, P = 0.001), widening of the CO(2) reserve (-3.8 ± 0.8 vs. -2.0 ± 0.3 Torr, P = 0.03), and a subsequent decline in AT (33.3 ± 1.2 vs. 39.0 ± 0.7 Torr; P = 001). The hypocapnic ventilatory response was also decreased with hyperoxia. In conclusion, 1) hyperoxia was associated with a decreased AT and an increase in the magnitude of hypocapnia required for the development of central apnea. 2) Thus hyperoxia may mitigate the effects of hypocapnia on ventilatory motor output by lowering the hypocapnic ventilatory response and lowering the resting eupneic PET(CO(2)), thereby decreasing plant gain.
本研究旨在确定高氧是否会降低非快速眼动(NREM)睡眠期间的低碳酸血症性呼吸暂停阈值(AT)。在稳定的 NREM 睡眠期间,使用鼻无创机械通气在健康受试者中诱导低碳酸血症和随后的中枢性呼吸暂停。机械通气试验在常氧(室内空气)和高氧条件(吸入 PO₂>250 托)下以随机顺序进行。CO₂储备定义为在正常通气和低碳酸血症性中枢性呼吸暂停之间的呼气末 PCO₂(PETCO₂)的最小变化。与正常通气最接近的呼吸暂停的 PETCO₂被指定为 AT。低碳酸血症性通气反应被定义为在给定的 PETCO₂变化下通气量低于正常通气量的变化。在 9 名参与者中,与室内空气相比,暴露于高氧与正常通气的 PETCO₂显著降低(37.5 ± 0.6 与 41.1 ± 0.6 Torr,P = 0.001)、CO₂储备增加(-3.8 ± 0.8 与 -2.0 ± 0.3 Torr,P = 0.03)和 AT 下降(33.3 ± 1.2 与 39.0 ± 0.7 Torr;P = 001)。低碳酸血症性通气反应也随高氧而降低。总之,1)高氧与 AT 降低以及发展中枢性呼吸暂停所需的低碳酸血症幅度增加有关。2)因此,高氧可能通过降低低碳酸血症性通气反应和降低静息正常通气的 PETCO₂,从而降低植物增益,从而减轻低碳酸血症对通气运动输出的影响。