The Regulation of Respiration During Sleep and Anesthesia

448 Pages·1978·11.16 MB·English

by  Robert S. Fitzgerald

THE REGULATION
OF RESPIRATION DURING
SLEEP AND ANESTHESIA
ADV ANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY
Editorial Board:
Nathan Back State University of New York at Buffalo
N. R. Di Luzio Tulane University School of Medicine
Bernard Halpern College de France and Institute of Immuno·Biology
Ephraim Katchalski The Weizmann Institute of Science
David Kritchevsky Wistar Institute
Abel Lajtha New York State Research Institute for Neurochemistry and Drug Addiction
Rodolfo Paoletti University of Milan
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THE REGULATION
OF RESPIRATION DURING
SLEEP AND ANESTHESIA
Edited by
Robert S. Fitzgerald
The Johns Hopkins University Medical Institutions
Baltimore, Maryland
Henry Gautier
Faculte de Medecine Saint-Antoine
Paris, France
and
Sukhama y Lahiri
University of Pennsylvania School of Medicine
Philadelphia, Pennsylvania
PLENUM PRESS • NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Symposium on Regulation of Respiration During Sleep and Anesthesia, Faculte de Medecine
Saint-Antoine, 1977.
The regulation of respiration during sleep and anesthesia.
(Advances in experimental medicine and biology; v. 99)
Includes index.
1. Respiration-Regulation-Congresses. 2. Sleep-Physiological aspects-Congresses. 3.
Anesthesia-Physiological aspects-Congresses. 4. Brain-Congresses. I. Fitzgerald, Robert,
1931- II. Gautier, Henry. III. Lahiri, Sukhamay. IV. Title. V. Series. [DNLM: 1
Anesthesia, General-Congresses. 2. Sleep-Congresses. 3. Respiration-Congresses. 4.
Respiration-Drug effects-Congresses. WI AD559 v. 99/WFI02 S992r 1977]
QP123.S951977 612'.2 78-6658
ISBN-13: 978-1-4613-4011-9 e-ISBN-13: 978-1-4613-4009-6
001: 10.1007/978-1-4613-4009-6
Proceedings of the Symposium on
Regulation of Respiration During Sleep and Anesthesia
held at the Faculte de Medecine Saint-Antoine,
Paris, France, July 14-16, 1977
© 1978 Plenum Press, New York
Softcover reprint of the hardcover 1s t edition 1978
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N.Y. 10011
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
PREFACE
During the 1976 Fall Meeting of the American Physiological
Society Dr. Lahiri and I learned that no plans were being formu
lated for holding a symposium on Respiratory Control during the
1977 International Congress. Not to hold such a symposium, we
felt, would be the loss of a unique opportunity for us "regula
tionists" to exchange ideas viva voce with our international
colleagues. It would also break a tradition most recently enjoyed
at Srinagar, India in 1974 and at Warsaw, Poland in 1971. After
a time-consuming false start we had the good fortune to get advice
from Dr. Pierre Dejours to make our plans known to Dr. Henry Gautier.
This we did. There resulted an excellent three days of discussion
and hospitality at the Faculte de Medecine Saint-Antoine in Paris
immediately preceding the International Congress.
The aim of the co-chairmen was to gather an international
mixture of both the younger and more senior experts to discuss,
argue, and maybe even agree on a point or two arising from their
current investigations. We wanted to feature, however, recent
research trying to determine the influence of sleep and anesthesia
on the regulation of respiration. That the sessions were lively
and presumably profitable was never more in evidence than when on
the second day at 6:15 p.m. after fully nine hours of discussion,
argumentation, and some agreement I counted 78 participants still
participating.
The symposium's proceedings which follow are divided into
four sections. The first section treats the influence of Sleep
and Anesthesia on the regulation of respiration. Fifteen papers
examine this influence on many systems--muscles of respiration,
central neural components, mechanical responses of the organism to
the classical stimuli of hypercapnia and hypoxia. The second
section treats the influence of Brain Acid-Base Environment on
respiratory regulation. Here seven papers discuss the response
of brain fluid composition to changes in the acid-base composition
of the plasma compartment under such conditions as the hypocapnic
hypoxia of altitude acclimatization, transient hypercapnia, and
metabolic derangement. Respiration both determines and is
determined by this fluid. The third section treats the influence
v
PREFACE
of Peripheral Input on the regulation of respiration. These
thirteen papers investigate influences on the shape and size of
the stimulus to the peripheral chemoreceptors, various aspects
of the chemoreceptors' dynamic response, the role of time of
central arrival of such activity on ventilation. New information
on airway receptors is presented as well. The fourth and final
section treats the influence of Central Interaction on the
regulation of respiration. Six papers focus on respiratory phase
switching and the interplay between peripheral and central chemo
receptor ~nput.
The co-chairmen have many people to thank. First, we give
very special thanks to the Dean, Professor J. Loygue, the Faculty
and the Staff of Faculte de Medecine Saint-Antoine for their generous
hospitality and untiring assistance during our three day meeting.
Their kindness and concern was ever present, but never more
appreciated by us than when they provided for our needs and comfort
on July 14, Bastille Day, their national holiday.
We gratefully acknowledge the financial assistance generously
given by the Respiratory Division of the Department of Medicine
of The Johns Hopkins University School of Medicine, Department of
Environmental Health Sciences of The Johns Hopkins University
School of Hygiene and Public Health, and The Institute for Environ
mental Medicine of The University of Pennsylvania.
We are grateful to all who contributed suggestions regarding
the contents, participants, and organization of the symposium.
Drs. Dan Cunningham and Curt von Euler were particularly helpful.
A symposium cannot exist without the stimulating contributions and
strong direction of chairmen, participants and discussants. We
thank you.
Finally, we thank Ms. Judy Wagner for her excellent work in
the preparation of the manuscripts.
Robert S. Fitzgerald
CONTENTS
Introduction to Section I: The Influence of
Sleep and Anesthesia. • • • • • • • • • • • • • • •• 1
"Regional Effects of Nembutal Anesthesia on
Brainstem Respiratory Neurones"
by A. Huge1in • • • • • • • • • • • ••• 5
"Effects of Anesthesia on Activity Patterns
of Respiratory Neurones" by A.L. Bianchi
and J.C. Bari110t •••••••••• 17
"Rate of Rise of Inspiration at Various
Levels of CNS Excitability" by W.A. Karczewski,
K. Budzinska, E. Nas10nska, E. Jazowiecka,
J .R. Romaniuk and M. Ryba • • • • • • • 23
"Breathing During Sleep in Man in Normal and
Pathological Conditions" by E. Lugaresi,
G. Coccagna, F. Cirignotta, P. Farneti,
R. Ga11assi, G. Di Donato and P. Verucchi 35
"Regulation of the Activity of Respiratory
Muscles During Sleep" by P.L. Parmeggiani 47
"Electric Activity of Cat Respiratory
Muscles During Sleep" by B. Duron,
D. Mar10t and M.C. Jung-Cai1101 •• 59
"Ventilatory Responses Mediated by Peripheral
Chemoreceptors in Anaesthetized Man" by
R.L. Knill, J.L. Clement and A.W. Ge1b. 67
"Effects of Sleep on the Pattern of CO
2
Stimulated Breathing in Males and Females"
by J. Newsom Davis, L. Loh, J. Nodal and
M. Charnock . . . . . . . . . . . . . . . . 79
vii
viii CONTENTS
"Breath-to-Breath Control of Ventilation in
Normal Infants During Sleep" by
G.G. Haddad, R.A. Epstein, M.A.F. Epstein,
N.M. Mazza, H.S. Law, J.S. Katz and
R.B. Me11ins •••••••••• ~. 85
"Effects of Anesthesia on Breathing Pattern"
by H. Gautier, J.H. Gaudy and M. Bonora ••• 93
"Interaction Between the Mechanical Properties
of the Respiratory System and Drive in the
Control of Breathing of Anesthetized Man"
by J.Ph. Derenne, J. Couture, W.A. Whitelaw
and J. Mi1ic-Emi1i. • • • • • • • • • • • • • • • • • 105
"'!he Effects of Fentanyl and '!hiopenta1 on
Breathing in Man" by M.D. Goldman,
T.H. MOrris, L.G. Kendall and L. Loh. 117
"Effects of Anesthesia and Muscle Paralysis
on the Mechanics of the Respiratory
Sys tem" by K. Rehder. • • • • • • • 125
"Apneic '!hresho1d in Intra-Operative
Anesthesia" by B.R. Manawadu and
G• D. Swanson. • • • • • 135
"MOuth Occlusion Pressure and EMG of the
Diaphragm in the Waking and Sleeping
States" by R.A. Freilich, M. Lopata and
R.V. Lourenfo • • • • • ••••••• 143
Introduction to Section II: The Influence
of Brain Acid-Base Environment •••••• 151
"Interaction of Humoral Ventilatory Stimuli
at High Altitude" by R. Lefranfois,
E. Vargas, M.F. He11ot, P •. Pasquis and
Ph. Denis • • • • • • • 153
"Carotid Chemoreceptor Role in CSF
Alkalosis at Altitude" by J.W. Severinghaus
and R.D. Crawford • • • • • • • • • • • • • 163
"Interaction Between PC02 and Plasma [HC03] in
Regulation of CSF [HC03] in Respiratory
Alkalosis and Metabolic Acidosis" by
H. Kazemi and S. Javaheri • • • • • • • • • • • • • • • • 173
CONTENTS ix
"02 Sensitive, Local Regulation of CSF
W Activity" by H. Makhzoumi,
R.J. Traystman, R.S. Fitzgerald,
B. Burns and G.H. Gurtner • 185
"Three Compartments Model for the Bicarbonate
Exchange of the Brain Extracellular Fluid
with Blood and Cells" by H.R. Ahmad,
H.H. Loeschcke and H.H. Woidtke • • • • • • • • • • • • • 195
"The Role of Chloride and Other Anions in
Cerebrospinal Fluid Bicarbonate Regulation"
by E.E. Nattie and L. Romer • • • • • • •• 211
"Depressant Effect of Ammonia on the
Ventilatory Response to Hypoxia and
Hypercapnia" by R.A. Berman, K.T. Meyer,
A.G. Rosenberg and R.E. Dutton ••••••• 219
Introduction to Section III: The Influence
of Peripheral Input • • 231
"Slow pH Changes in Blood Plasma Following
CO Exchange" by E.P. Hill, G.G. Power
2
and R.D. Gilbert •••••••••••• 233
"Delayed pH Equilibration in Blood During
Carbonic Anhydrase Inhibition" by
E.D. Crandall, A. Bidani and R.E. Forster 243
"Pulmonary Carbonic Anhydrase and the
Release of Carbon Dioxide from Plasma
Bicarbonate" by R.M. Effros • • • • • 255
"Aortic Nerve Chemoreceptors are Sensitive
to Changes in PaC02" by M.A. Hanson,
P.S. Rao and R.W. Torrance •••••••• 269
"The Effects of Changes in Arterial
Pressure on Sinus Nerve Efferent
Activity" by P. Willshaw and
S. Majcherczyk •••••••••• 275
"Chemical Stimulation of Rapidly Adapting
Receptors in the Airways" by S.R. Sampson
and E.H. Vidruk • • • • • • • • • • • • • 281
x CONTENTS
"Comparison of the Effects of Histamine
and Prostaglandin on Afferent C-Fiber
Endings and Irritant Receptors in the
Intrapulmonary Airways" by H.M. Coleridge,
J.C.G. Coleridge, D.G. Baker, K.H. Ginze1
and M.A. Morrison • •• • • • • • • • • 291
"Stretch Receptors of the Trachea" by
G. Sant'Ambrogio, J.P. Morto1a and
C.M. Severin ••••••••• 307
"A Comparison of the Effects of Steady-State
and Progressive Hypoxia on the Ventilatory
and Frequency Response" by C.K. Mahutte,
W.E. Woodley and A.S. Rebuck •••••••• 315
"The Different Respiratory Effects of
Inspiratory and Expiratory Stimulations
of the Carotid Sinus Nerve and Carotid
Body" by F.L. Eldridge. • • • • • • • • 325
"Carotid Arterial Blood Gas Oscillations
and the Phase of the Respiratory Cycle
During Exercise in Man: Testing a Model"
by E. Strange-Petersen, B.J. Whipp,
D.B. Drysdale and D.J.C. Cunningham •• 335
"Significance of Peripheral Chemoreceptor
Response and Adaptation in the Regulation
of Breathing" by S. Lahiri, R. Gelfand,
A. Mokashi and T. Nishino •••••• 343
"Ventilatory Control Characteristics of
Conditions Resulting in Isocapnic
Hyperpnea" by B.J. Whipp, K. Wasserman,
R. Casaburi, C.E. Juratsch, M.L. Weissman
and R.W. Streme1. •• • ••••••• 355
Introduction to Section IV: The Influence
of Central Interaction. • 367
"Central Mechanisms Controlling Expiratory
Duration" by M.l. Cohen and J.L. Feldman. 369
"Termination of Inspiration Through Graded
Inhibition of Inspiratory Activity" by
M. Younes, J.P. Baker, J. Po1acheck and
J • E. Rennners. • • • • • • • • • • • 383