Oxygen-induced hypercarbia in obstructive pulmonary disease

W. F. Dunn, S. B. Nelson, R. D. Hubmayr

Research output: Contribution to journalArticle

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Abstract

We investigated the mechanisms responsible for oxygen-induced hypercarbia in ventilator-dependent patients with advanced chronic obstructive pulmonary disease (COPD). To quantitate the effects of oxygen (O 2) on respiratory drive, we determined the CO 2 recruitment threshold (P(CO 2) RT) in 10 mechanically ventilated patients under normoxic (Pa(O 2) = 67 ± 7 mm Hg) and hyperoxic (Pa(O 2) = 370 ± 67 mm Hg) conditions. P(CO 2) RT is a measure of the CO 2 responsiveness of the mechanically unloaded respiratory system and, as such, is independent of mechanical impedance and respiratory muscle strength. After O 2 supplementation, P(CO 2) RT increased from 42 ± 6 to 45 ± 6 mm Hg (p ≤ 0.05), indicating a suppression of so-called hypoxic respiratory drive. The effect of hyperoxia on the dead space to tidal volume ratio (VD/VT) and CO 2 elimination (V̇(CO 2)) was studied in 6 patients. Measurements were made at identical ventilator settings, thus eliminating breathing pattern- and respiratory work-related effects on these variables. VD/VT rose from 0.49 ± 0.09 to 0.55 ± 0.06 (p ≤ 0.05), but V̇(CO 2) remained constant at 0.21 L/min. We discuss why measuring O 2-induced changes in minute ventilation, V̇(CO 2), Pa(O 2), and VD/VT in spontaneously breathing patients is insufficient to distinguish between gas exchange- and respiratory drive-related mechanisms for hypercarbia. Based on the O 2-induced increase in P(CO 2) RT, we conclude that so-called suppression of hypoxic drive plays an important role in the pathogenesis of this disorder.

Original languageEnglish (US)
Pages (from-to)526-530
Number of pages5
JournalAmerican Review of Respiratory Disease
Volume144
Issue number3 I
StatePublished - 1991

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Obstructive Lung Diseases
Hypercapnia
Carbon Monoxide
Oxygen
Mechanical Ventilators
Respiration
Hyperoxia
Respiratory Muscles
Tidal Volume
Muscle Strength
Electric Impedance
Respiratory System
Chronic Obstructive Pulmonary Disease
Ventilation
Gases

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Dunn, W. F., Nelson, S. B., & Hubmayr, R. D. (1991). Oxygen-induced hypercarbia in obstructive pulmonary disease. American Review of Respiratory Disease, 144(3 I), 526-530.

Oxygen-induced hypercarbia in obstructive pulmonary disease. / Dunn, W. F.; Nelson, S. B.; Hubmayr, R. D.

In: American Review of Respiratory Disease, Vol. 144, No. 3 I, 1991, p. 526-530.

Research output: Contribution to journalArticle

Dunn, WF, Nelson, SB & Hubmayr, RD 1991, 'Oxygen-induced hypercarbia in obstructive pulmonary disease', American Review of Respiratory Disease, vol. 144, no. 3 I, pp. 526-530.
Dunn, W. F. ; Nelson, S. B. ; Hubmayr, R. D. / Oxygen-induced hypercarbia in obstructive pulmonary disease. In: American Review of Respiratory Disease. 1991 ; Vol. 144, No. 3 I. pp. 526-530.
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