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By J. F. Nunn
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Additional info for Applied Respiratory Physiology. With Special Reference to Anaesthesia
P c o 2 might be more appropriate and these have been shown to give particularly straight curves. Alternatively, in the clinical environment it may be more convenient to use end-expiratory P c o 2 as a substitute for arterial P c o 2 although this is not satisfactory in conditions such as chronic bronchitis, which are associated with a marked arterial/ end-expiratory P c o 2 difference (see Chapter 11). Methods of obtaining response curves are summarized at the end of this chapter. —Displacement of the Pco 2/ventilation response 5 curve is probably the best way of defining the 'depressant or 'stimulant' effect of a drug on ventilation.
It should also be noted that Cozine and Ngai (1967), working with unanaesthetized (decerebrate) cats with denervated peripheral chemoreceptors, found that apnoea did not follow the application of local anaesthetics to the central chemoreceptor areas on the antero-lateral surface of the medulla, although the minute volume of ventilation was reduced. In anaesthetized cats apnoea was obtained. These studies suggested that the influence of the central chemoreceptors was at least shared with other zones, possibly more deeply placed.
Division of the afferent nerves from the peripheral chemoreceptors does not greatly diminish the ventilatory response to elevation of the arterial P c o 2 and it has been generally believed that the respiratory centre is itself sensitive to carbon dioxide. Recent work, however, suggests that the central chemoreceptors, as they have come to be called, may actually be separate from the respiratory neurones of the medulla although located but a short distance away. There has also been a recent revival of interest in the possibility of the existence of central venous chemoreceptors.
Applied Respiratory Physiology. With Special Reference to Anaesthesia by J. F. Nunn