Baier H, Somani P
Chest. 1984 Feb;85(2):222-5. doi: 10.1378/chest.85.2.222.
The effects of reduced caloric intake on ventilatory drive were investigated in normal volunteers. During a ten-day semistarvation period, six subjects (group 1) received parenterally an amino acid solution providing 550 kcal/d sufficient to prevent a negative nitrogen balance. Six subjects (group 2) received in addition a safflower oil solution providing a total caloric intake of 1,100 kcal/d. Hypoxic ventilatory drive was estimated by an index (parameter A) of the relation between minute ventilation (VE) and hypoxia. In group 1, mean values (+/- SEM) of A decreased significantly from 161.5 (+/- 42.0) to 48.9 (+/- 12.0) by day 10 (p less than 0.05), indicating a severe depression of hypoxic drive despite a positive nitrogen balance. In group 2, A did not change significantly (p greater than 0.05) from control values indicating a preserved hypoxic ventilatory drive. In both groups, the slopes of the line relating VE to arterial PCO2 (delta VE/delta PaCO2) did not change significantly during the ten-day semistarvation period consistent with preservation of the hypercapnic ventilatory drive. These data indicate that during periods of starvation, parenteral administration of aminoacids in an amount sufficient to maintain nitrogen balance is inadequate to prevent depression of respiratory control mechanisms unless a minimum daily caloric intake is achieved.
在正常志愿者中研究了热量摄入减少对通气驱动的影响。在为期十天的半饥饿期内,六名受试者(第1组)经肠胃外给予一种氨基酸溶液,提供550千卡/天的热量,足以防止负氮平衡。另外六名受试者(第2组)还接受了一种红花油溶液,使总热量摄入达到1100千卡/天。通过分钟通气量(VE)与低氧之间关系的一个指数(参数A)来估计低氧通气驱动。在第1组中,到第10天时,A的平均值(±标准误)从161.5(±42.0)显著降至48.9(±12.0)(p<0.05),这表明尽管氮平衡为正,但低氧驱动仍严重受抑。在第2组中,A与对照值相比无显著变化(p>0.05),表明低氧通气驱动得以保留。在两组中,在为期十天的半饥饿期内,VE与动脉血PCO2关系曲线的斜率(δVE/δPaCO2)均无显著变化,这与高碳酸血症通气驱动得以保留一致。这些数据表明,在饥饿期间,经肠胃外给予足以维持氮平衡的氨基酸量不足以防止呼吸控制机制受抑,除非达到每日最低热量摄入量。