Duffin J
Department of Anaesthesia, University of Toronto, Ontario, Canada.
Can J Anaesth. 1990 Nov;37(8):933-42. doi: 10.1007/BF03006641.
The chemoreflex control of breathing is described in terms of a graphical model. The central chemoreflex, the ventilatory response to carbon dioxide mediated by the central chemoreceptors, is modelled as a straight-line relation between the ventilatory response and the arterial level of carbon dioxide. The peripheral chemoreflex, the ventilatory response to carbon dioxide and hypoxia mediated by the peripheral chemoreceptors, is broken into two relations. First, a straight-line relation between the ventilatory response and the arterial level of carbon dioxide whose slope (sensitivity) increases as the oxygen level varies from hyperoxic to hypoxic. Second, a rectangular hyperbolic relation between the ventilatory response and the arterial level of oxygen with ventilation increasing with increasing hypoxia. The three ventilatory response relations (one central and two peripheral) add to produce the total chemoreflex ventilatory response which forms the feedback part of the respiratory regulator. The forward part consists of the relation between the arterial level of carbon dioxide and ventilation when ventilation is controlled (the metabolic hyperbola). The forward and feedback parts of the respiratory regulator can be combined so as to predict resting ventilation and carbon dioxide levels under a number of circumstances. Methods of measurement of these chemoreflex ventilatory responses are also described so as to illustrate the physiological principles involved in the model.
呼吸的化学反射控制是通过一个图形模型来描述的。中枢化学反射,即由中枢化学感受器介导的对二氧化碳的通气反应,被建模为通气反应与动脉血二氧化碳水平之间的直线关系。外周化学反射,即由外周化学感受器介导的对二氧化碳和低氧的通气反应,分为两个关系。第一,通气反应与动脉血二氧化碳水平之间的直线关系,其斜率(敏感性)随着氧水平从高氧到低氧的变化而增加。第二,通气反应与动脉血氧水平之间的矩形双曲线关系,通气随着低氧程度的增加而增加。这三种通气反应关系(一种中枢的和两种外周的)相加产生总的化学反射通气反应,它构成了呼吸调节器的反馈部分。前向部分由通气受控制时动脉血二氧化碳水平与通气之间的关系(代谢双曲线)组成。呼吸调节器的前向和反馈部分可以结合起来,以便预测在多种情况下的静息通气和二氧化碳水平。还描述了测量这些化学反射通气反应的方法,以说明模型中涉及的生理原理。