Mortola J P, Rezzonico R
Department of Physiology, McGill University, Montreal, Quebec, Canada.
Respir Physiol. 1988 Jul;73(1):55-67. doi: 10.1016/0034-5687(88)90127-2.
Newborns respond to acute hypoxia with a brief increase in ventilation (VE) followed by a decline toward the normoxic value. We asked to what extent this biphasic pattern is determined by changes in metabolic rate. In newborn awake kittens within the first week after birth we measured VE by the barometric method, oxygen consumption (VO2) and CO2 production (VCO2) by manometric techniques during air breathing and after 10 min of 10% O2 breathing. In hypoxia, VO2 and VCO2 dropped (about 45% and 35%, respectively) with a slight decrease in body temperature. VE was as in normoxia and, from the changes in breathing pattern, a drop in alveolar ventilation was calculated. Since the drop in VCO2 exceeded that in calculated alveolar ventilation (VA), a decrease in PACO2 (estimated at about 5 mm Hg) was expected. This decrement was confirmed by measurements of transcutaneous PCO2, which dropped an average of 3.3 mm Hg in the hypoxic kittens, even when VE was below the normoxic value. Hence, despite the decline in VE and VA during the biphasic response, the newborn continued to hyperventilate with respect to CO2 production, lowering PCO2. The strategy of dropping VO2 instead of maintaining the energetic requirements by increasing VE was not determined by mechanical constraints, since all kittens hyperventilated when exposed to CO2, either in air or hypoxia. Several implications of the tight coupling between ventilation and metabolism are discussed, including a possible role in the genesis of periodic breathing in hypoxia.
新生儿对急性缺氧的反应是通气量(VE)短暂增加,随后降至正常氧水平值。我们研究了这种双相模式在多大程度上由代谢率的变化所决定。在出生后第一周内的清醒新生小猫中,我们通过气压法测量VE,通过压力测量技术在空气呼吸时以及呼吸10%氧气10分钟后测量氧气消耗量(VO2)和二氧化碳产生量(VCO2)。在缺氧状态下,VO2和VCO2下降(分别约为45%和35%),体温略有下降。VE与正常氧水平时相同,根据呼吸模式的变化计算出肺泡通气量下降。由于VCO2的下降超过了计算出的肺泡通气量(VA)的下降,预计动脉血二氧化碳分压(PACO2)会降低(估计约为5毫米汞柱)。经皮二氧化碳分压的测量证实了这种下降,即使VE低于正常氧水平值,缺氧小猫的经皮二氧化碳分压平均下降了3.3毫米汞柱。因此,尽管在双相反应期间VE和VA下降,但新生儿相对于二氧化碳产生量仍持续过度通气,降低了PCO2。通过降低VO2而不是通过增加VE来维持能量需求的策略并非由机械限制决定,因为所有小猫在空气或缺氧环境中暴露于二氧化碳时都会过度通气。本文讨论了通气与代谢之间紧密耦合的几个影响,包括其在缺氧时周期性呼吸发生中的可能作用。