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The ventilatory recruitment threshold for carbon dioxide.

G C Prechter1, S B Nelson, R D Hubmayr

  • 1Division of Thoracic Diseases and Internal Medicine, Mayo Clinic, Rochester, MN 55905.

The American Review of Respiratory Disease
|March 1, 1990
PubMed
Summary

This study introduces a new method to measure the respiratory controller's response to CO2, defining a CO2 recruitment threshold (PCO2RT). This technique aids in assessing respiratory failure patients without mechanical interference.

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Area of Science:

  • Respiratory Physiology
  • Critical Care Medicine
  • Pulmonary Function Testing

Background:

  • Assessing chemoresponsiveness of the respiratory controller is crucial for managing respiratory failure.
  • Existing methods may be confounded by respiratory system mechanics or inspiratory muscle function.
  • A reliable, load-independent measure of respiratory controller chemoresponsiveness is needed.

Purpose of the Study:

  • To introduce and evaluate a novel technique for characterizing respiratory controller chemoresponsiveness.
  • To define the CO2 recruitment threshold (PCO2RT) as a measure of inspiratory on-switch to CO2.
  • To explore the clinical utility of PCO2RT in critically ill patients.

Main Methods:

  • Mechanical ventilation was used to suppress spontaneous respiratory muscle activity.

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  • The CO2 recruitment threshold (PCO2RT) was determined as the minimum alveolar CO2 tension triggering inspiratory efforts during CO2 supplementation.
  • Inspiratory muscle recruitment was monitored via airway pressure/flow, chest wall displacement, and diaphragm electromyogram.

    • Main Results:

    • PCO2RT was reproducibly measured within subjects, independent of ventilator settings and lung volume.
    • The technique allows characterization of chemoresponsiveness without mechanical loading.
    • Inspiratory muscle recruitment could be reliably inferred from multiple physiological signals.

    Conclusions:

    • The CO2 recruitment threshold (PCO2RT) offers a reliable method to assess respiratory controller chemoresponsiveness.
    • This technique is valuable for studying ventilatory requirements and load responses in respiratory failure.
    • PCO2RT provides a load-independent assessment, enhancing its utility in critically ill populations.