Adaptations of quadriplegic men to consecutively loaded breaths

Ventilatory responses to graded elastic and resistive loads from 20 quadriplegic men were analyzed. During the 1st, 5th, and 10th consecutively loaded inspirations 1) responses from different subjects ranged from a weak tidal volume defense coupled with an increased breathing frequency to a strong tidal volume defense coupled with a decreased frequency; 2) strong tidal volume defenders generally employed longer inspirations than did weak tidal volume defenders; and 3) individual respiratory frequencies were mediated by similar changes in inspiratory and/or expiratory timing. Thus the group response was qualitatively similar on the 1st, 5th, and 10th loaded breaths. Quantitatively, however, minute ventilation increased throughout each 10-breath episode due to progressively larger tidal volumes coupled with equal breathing frequencies. These larger tidal volumes were due to progressively stronger inspirations with no changes in timing during elastic loading, whereas they were due to both stronger and longer inspirations during resistive loading. These findings, which are qualitatively the same as those found in healthy subjects, indicate that sensory input from the mouth, lung, and diaphragm, and motor output to the diaphragm and accessory muscles are sufficient, by themselves, to mediate normal patterns of ventilatory adjustments during consecutively loaded breaths.