意识清醒的人吸入二氧化碳时，推测大脑皮层参与通气反应。

Putative cerebral cortical involvement in the ventilatory response to inhaled CO2 in conscious man.

Murphy K, Mier A, Adams L, Guz A

Department of Medicine, Charing Cross and Westminster Medical School, London.

J Physiol. 1990 Jan;420:1-18. doi: 10.1113/jphysiol.1990.sp017898.

Abstract

The response of the diaphragm to both transcranial magnetic stimulation and electrical phrenic nerve stimulation was studied in thirteen normal subjects under conditions of either a 'reflex' drive to ventilation with inhaled CO2 or during volitional ventilation of similar magnitude. 2. The induced compound action potential in the diaphragm was recorded using an oesophageal electrode, and in some cases transdiaphragmatic pressure was recorded using oesophageal and gastric balloon catheters. 3. The response of the diaphragm to transcranial magnetic stimulation was invariably facilitated with volitional inspiration; there was either minimal or no response at functional residual capacity. 4. Facilitation with inspiration was also seen during a 'reflex' drive to ventilation with inhaled CO2 in the presumed absence of any volitional contribution to ventilation. A similar degree of facilitation was seen with voluntary ventilation of similar magnitude and pattern. 5. If the facilitation is predominantly a cortical phenomenon, then these results imply that there is a behavioural component in the previously supposed purely 'reflex' drive to ventilation with inhaled CO2. We also discuss the interpretation of these results if some of the facilitation occurs at the phrenic motoneurone.

摘要

在13名正常受试者中，研究了在吸入二氧化碳进行“反射性”通气驱动或类似幅度的自主通气条件下，膈肌对经颅磁刺激和膈神经电刺激的反应。2. 使用食管电极记录膈肌中的诱发性复合动作电位，在某些情况下，使用食管和胃气囊导管记录跨膈压。3. 膈肌对经颅磁刺激的反应在自主吸气时总是增强；在功能残气量时反应最小或无反应。4. 在假定对通气无任何自主贡献的情况下，吸入二氧化碳进行“反射性”通气驱动时，吸气时也可见反应增强。在类似幅度和模式的自主通气时也观察到类似程度的增强。5. 如果这种增强主要是一种皮质现象，那么这些结果意味着在先前假定的纯粹由吸入二氧化碳引起的“反射性”通气驱动中存在行为成分。我们还讨论了如果部分增强发生在膈运动神经元时这些结果的解释。