Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, United States of America.
Office of Research and Development, US Environmental Protection Agency, Research Triangle Park, NC, United States of America.
J Breath Res. 2021 Sep 27;15(4). doi: 10.1088/1752-7163/ac2589.
Normal breathing for healthy humans is taken for granted; it occurs without conscious effort using ambient (1-atmosphere) pressure with 21% oxygen (O) concentration. The body automatically adjusts for stress, exercise, altitude, and mild disease by increasing the volume and frequency of breathing. Longer term adaptations for exercise and altitude include increases in red blood cell counts and higher concentrations of capillaries in muscle tissue. When more challenging external environmental conditions or pulmonary illnesses exceed the capability for these adaptations, the human system requires technology to maintain sufficient ventilation to preserve life. On the environmental side there are two conditions to be addressed: toxicity of the surrounding atmosphere and changes in external pressure and Oconcentration. On the medical side, mechanisms for assisting breathing include Osupplementation at ambient pressure, positive pressure/flow without additional O, or a combination of both. This overview describes the various technologies applied to maintaining a safe breathing environment. Topics for environmental intervention include filter-based and flowing air-supply masks for toxic environments (occupational and laboratory protection), and on-demand gas supply systems for firefighters, self-contained underwater breathing apparatus divers, and altitude (high performance aircraft, spacecraft) applications. The topics for medical intervention include nasal cannula, continuous positive airway pressure, and medical ventilators. The primary purpose of this article is to provide a basic understanding of normal human breathing and the adaptation of breathing in different environments using available technologies.
健康人正常呼吸是理所当然的;它无需有意识的努力,使用大气压力(1 个大气压)和 21%氧气(O)浓度。身体会自动通过增加呼吸的体积和频率来适应压力、运动、海拔和轻度疾病。对于运动和海拔的长期适应包括增加红细胞计数和肌肉组织中毛细血管的更高浓度。当更具挑战性的外部环境条件或肺部疾病超过这些适应能力时,人体系统需要技术来维持足够的通风以维持生命。在环境方面,有两个条件需要解决:周围大气的毒性和外部压力和 O 浓度的变化。在医疗方面,辅助呼吸的机制包括在大气压力下补充 O、无额外 O 的正压/流量,或两者的组合。本文概述了用于维持安全呼吸环境的各种技术。环境干预的主题包括用于有毒环境的基于过滤器的和流动空气供应面罩(职业和实验室保护),以及消防员、自给式水下呼吸器潜水员和高空(高性能飞机、航天器)应用的按需气体供应系统。医疗干预的主题包括鼻插管、持续气道正压和医用呼吸机。本文的主要目的是提供对正常人类呼吸以及使用现有技术在不同环境中呼吸适应的基本了解。