Ventilatory response to hypoxia in experimental pathology of the diaphragm

In this study, we examined the usefulness of arterial blood gas variables, as changed by the hypoxic stimulus, in discerning various experimentally-induced conditions of diaphragm weakness in anesthetized cats. We defined three experimental situations (models): (i) intact muscle, statistical Class I, (ii) four degrees of muscle dysfunction (after sequential diaphragm denervation), Classes II-V, and (iii) entirely paralyzed muscle, Class VI. Responses to a hypoxic stimulus in the above-mentioned conditions were evaluated by using the methods of the pattern recognition theory. We found that before the hypoxic stimulus, with partial but of different severity denervation of the diaphragm, the k-nearest neighbor classifier (k-NN) assigned 100% of the classified cases to Class II (one phrenic nerve rootlet cut). In contrast, during hypoxia only 67% of cases were assigned to Class II, the remaining being spread throughout other classes of muscle weakness. When one limits the procedure to the extreme classes: Class I (intact diaphragm) and Class VI (totally denervated diaphragm), the k-NN picks out 33% and 50% cases of bilateral diaphragm paralysis before and during hypoxia, respectively. We conclude that any remaining innervations of the diaphragm ensure the functionally optimal level of lung ventilation that may waver when hypoxia develops.