The ventilatory recruitment threshold for carbon dioxide

G. C. Prechter, S. B. Nelson, R. D. Hubmayr

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

We report our initial experience with a technique with which the chemoresponsiveness of the respiratory controller can be characterized in terms of an inspiratory on-switch threshold to CO2. After suppression of phasic respiratory muscle activity by mechanical ventilation, a CO2 recruitment threshold (PCO2RT) was defined as the lowest alveolar CO2 tension at which CO2 supplementation to inspired gas caused a reappearance of inspiratory efforts. Because PCO2RT can be determined in the absence of a mechanical load on the ventilatory pump, respiratory system mechanics and inspiratory muscle function should not influence the measurement itself. Thus, this technique may be helpful to study ventilatory requirements and load responses in critically ill patients with respiratory failure. We have shown that inspiratory muscle recruitment can be equally well-inferred from changes in the airway pressure and flow tracings during mechanical ventilation, from the pattern of chest wall displacement, and from the integrated diaphragm electromyogram. Within a subject, PCO2RT is a reproducible measurement that is not influenced by ventilator settings and end-expiratory lung volume, provided that phasic respiratory muscle has been suppressed prior to CO2 supplementation. Details of the methodology, the likely determinants of PCO2RT, and the clinical utility of this technique are discussed.

Original languageEnglish (US)
Pages (from-to)758-764
Number of pages7
JournalAmerican Review of Respiratory Disease
Volume141
Issue number3 I
StatePublished - 1990

Fingerprint

Respiratory Muscles
Artificial Respiration
Carbon Dioxide
Respiratory Mechanics
Muscles
Thoracic Wall
Electromyography
Mechanical Ventilators
Diaphragm
Critical Illness
Respiratory Insufficiency
Respiratory System
Gases
Pressure
Lung

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Prechter, G. C., Nelson, S. B., & Hubmayr, R. D. (1990). The ventilatory recruitment threshold for carbon dioxide. American Review of Respiratory Disease, 141(3 I), 758-764.

The ventilatory recruitment threshold for carbon dioxide. / Prechter, G. C.; Nelson, S. B.; Hubmayr, R. D.

In: American Review of Respiratory Disease, Vol. 141, No. 3 I, 1990, p. 758-764.

Research output: Contribution to journalArticle

Prechter, GC, Nelson, SB & Hubmayr, RD 1990, 'The ventilatory recruitment threshold for carbon dioxide', American Review of Respiratory Disease, vol. 141, no. 3 I, pp. 758-764.
Prechter, G. C. ; Nelson, S. B. ; Hubmayr, R. D. / The ventilatory recruitment threshold for carbon dioxide. In: American Review of Respiratory Disease. 1990 ; Vol. 141, No. 3 I. pp. 758-764.
@article{2874cf55fce64415855746d5e93f8b55,
title = "The ventilatory recruitment threshold for carbon dioxide",
abstract = "We report our initial experience with a technique with which the chemoresponsiveness of the respiratory controller can be characterized in terms of an inspiratory on-switch threshold to CO2. After suppression of phasic respiratory muscle activity by mechanical ventilation, a CO2 recruitment threshold (PCO2RT) was defined as the lowest alveolar CO2 tension at which CO2 supplementation to inspired gas caused a reappearance of inspiratory efforts. Because PCO2RT can be determined in the absence of a mechanical load on the ventilatory pump, respiratory system mechanics and inspiratory muscle function should not influence the measurement itself. Thus, this technique may be helpful to study ventilatory requirements and load responses in critically ill patients with respiratory failure. We have shown that inspiratory muscle recruitment can be equally well-inferred from changes in the airway pressure and flow tracings during mechanical ventilation, from the pattern of chest wall displacement, and from the integrated diaphragm electromyogram. Within a subject, PCO2RT is a reproducible measurement that is not influenced by ventilator settings and end-expiratory lung volume, provided that phasic respiratory muscle has been suppressed prior to CO2 supplementation. Details of the methodology, the likely determinants of PCO2RT, and the clinical utility of this technique are discussed.",
author = "Prechter, {G. C.} and Nelson, {S. B.} and Hubmayr, {R. D.}",
year = "1990",
language = "English (US)",
volume = "141",
pages = "758--764",
journal = "American Journal of Respiratory and Critical Care Medicine",
issn = "1073-449X",
publisher = "American Thoracic Society",
number = "3 I",

}

TY - JOUR

T1 - The ventilatory recruitment threshold for carbon dioxide

AU - Prechter, G. C.

AU - Nelson, S. B.

AU - Hubmayr, R. D.

PY - 1990

Y1 - 1990

N2 - We report our initial experience with a technique with which the chemoresponsiveness of the respiratory controller can be characterized in terms of an inspiratory on-switch threshold to CO2. After suppression of phasic respiratory muscle activity by mechanical ventilation, a CO2 recruitment threshold (PCO2RT) was defined as the lowest alveolar CO2 tension at which CO2 supplementation to inspired gas caused a reappearance of inspiratory efforts. Because PCO2RT can be determined in the absence of a mechanical load on the ventilatory pump, respiratory system mechanics and inspiratory muscle function should not influence the measurement itself. Thus, this technique may be helpful to study ventilatory requirements and load responses in critically ill patients with respiratory failure. We have shown that inspiratory muscle recruitment can be equally well-inferred from changes in the airway pressure and flow tracings during mechanical ventilation, from the pattern of chest wall displacement, and from the integrated diaphragm electromyogram. Within a subject, PCO2RT is a reproducible measurement that is not influenced by ventilator settings and end-expiratory lung volume, provided that phasic respiratory muscle has been suppressed prior to CO2 supplementation. Details of the methodology, the likely determinants of PCO2RT, and the clinical utility of this technique are discussed.

AB - We report our initial experience with a technique with which the chemoresponsiveness of the respiratory controller can be characterized in terms of an inspiratory on-switch threshold to CO2. After suppression of phasic respiratory muscle activity by mechanical ventilation, a CO2 recruitment threshold (PCO2RT) was defined as the lowest alveolar CO2 tension at which CO2 supplementation to inspired gas caused a reappearance of inspiratory efforts. Because PCO2RT can be determined in the absence of a mechanical load on the ventilatory pump, respiratory system mechanics and inspiratory muscle function should not influence the measurement itself. Thus, this technique may be helpful to study ventilatory requirements and load responses in critically ill patients with respiratory failure. We have shown that inspiratory muscle recruitment can be equally well-inferred from changes in the airway pressure and flow tracings during mechanical ventilation, from the pattern of chest wall displacement, and from the integrated diaphragm electromyogram. Within a subject, PCO2RT is a reproducible measurement that is not influenced by ventilator settings and end-expiratory lung volume, provided that phasic respiratory muscle has been suppressed prior to CO2 supplementation. Details of the methodology, the likely determinants of PCO2RT, and the clinical utility of this technique are discussed.

UR - http://www.scopus.com/inward/record.url?scp=0025268016&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025268016&partnerID=8YFLogxK

M3 - Article

VL - 141

SP - 758

EP - 764

JO - American Journal of Respiratory and Critical Care Medicine

JF - American Journal of Respiratory and Critical Care Medicine

SN - 1073-449X

IS - 3 I

ER -