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Updated: May 8, 2026

Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
Episodic ventilation lowers the efficiency of pulmonary CO2 excretion
Christian Lind Malte1, Hans Malte, Tobias Wang
1Zoophysiology, Department of Bioscience, Aarhus University, Aarhus, Denmark.
Abstract:
The ventilation pattern of many ectothermic vertebrates, as well as hibernating and diving endotherms, is episodic where breaths are clustered in bouts interspersed among apneas of varying duration. Using mechanically ventilated, anesthetized freshwater turtles (Trachemys scripta), a species that normally exhibits this episodic ventilation pattern, we investigated whether episodic ventilation affects pulmonary gas exchange compared with evenly spaced breaths. In two separate series of experiments (a noninvasive and an invasive), ventilation pattern was switched from a steady state, with evenly spaced breaths, to episodic ventilation while maintaining overall minute ventilation (30 ml·min(-1)·kg(-1)). On switching to an episodic ventilation pattern of 10 clustered breaths, mean CO2 excretion rate was reduced by 6 ± 5% (noninvasive protocol) or 20 ± 8% (invasive protocol) in the first ventilation pattern cycle, along with a reduction in the respiratory exchange ratio. O2 uptake was either not affected or increased in the first ventilation pattern cycle, while neither heart rate nor overall pulmonary blood flow was significantly affected by the ventilation patterns. The results confirm that, for a given minute ventilation, episodic ventilation is intrinsically less efficient for CO2 excretion, thereby indicating an increase in the total bodily CO2 store in the protocol. Despite the apparent CO2 retention, mean arterial Pco2 only increased 1 Torr during the episodic ventilation pattern, which was concomitant with a possible reduction of respiratory quotient. This would indicate a shift in metabolism such that less CO2 is produced when the efficiency of excretion is reduced.
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