Immediate Effects of Bilateral Carotid Body Resection on Total Respiratory Resistance and Compliance in Humans

  • Benjamin Winter
  • Brian J. Whipp
Conference paper
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 551)


In 1962, Nadel and Widdicombe1 conclusively demonstrated a reflex increase in airways resistance (Raw) in response to carotid body stimulation in the dog. This effect could be eliminated by blocking either the glossopharyngeal or vagus nerves, i.e. the afferent or efferent limbs of the reflex respectively. That the peripheral chemoreceptors not only act reflexly on respiration but also cause reflex bronchoconstriction was also stressed by Widdicombe2 in his review of “Chemoreceptor Control of the Airways.” This is among the reasons often cited as a basis for potential benefits that might accrue from bilateral carotid body resection (BCBR) in patients with severe chronic obstructive pulmonary disease (COPD).3


Chronic Obstructive Pulmonary Disease Chronic Obstructive Pulmonary Disease Patient Carotid Body Severe Chronic Obstructive Pulmonary Disease Total Lung Capacity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    J. A. Nadel, and J. G. Widdicombe, Effects of changes in blood gas tensions ans carotid sinus pressure on tracheal volume and total lung resistance to air flow. J. Physiol. (Land.) 163, 13–33 (1962).Google Scholar
  2. 2.
    J. G. Widdicombe, Chemoreceptor control of the airways. Respir. Physiol. 87, 373–381 (1992).CrossRefPubMedGoogle Scholar
  3. 3.
    B. Winter, Carotid body resection: Controversy-confusion-conflict. Ann. Thorac. Surg. 16, 648–659 (1973).PubMedGoogle Scholar
  4. 4.
    P. Vermeire, W. de Backer, R. van Maele, J. Bal, and W. van Kerckhoven, Carotid body resection in patients with severe chronic airflow limitation. Clin. Respir. Physiol. 23(suppl. 11), 165S–166S (1987).Google Scholar
  5. 5.
    B. J. Whipp, and S. A. Ward, Physiologic changes following bilateral carotid-body resection in patients with chronic obstructive pulmonary disease. Chest 101, 656–661 (1992).CrossRefPubMedGoogle Scholar
  6. 6.
    B. Winter, Surgical treatment of asthma, chronic bronchitis and emphysema by bilateral carotid body resection. Respir. Ther. 5, 8–28 (1975).Google Scholar
  7. 7.
    Y. Honda, S. Watanabe, I. Hashizume, Y. Satomura, N. Hata, Y. Sakibara, and J. W. Severinghaus, Hypoxic chemosensitivity in asthmatic patients two decades after carotid body resection. J. Appl. Physiol. 46, 632–638 (1979).PubMedGoogle Scholar
  8. 8.
    B. Winter, Bilateral carotid body resection for asthma and emphysema: a new surgical approach without hypoventilation or baroreceptor dysfunction. Int. Surg. 57, 458–464 (1972).PubMedGoogle Scholar
  9. 9.
    L. Nordstrom, On automatic ventilation. Acta Anaesth. Scand. 47(suppl.), 1–56 (1972).Google Scholar
  10. 10.
    R. Lugliani, B. J. Whipp, C. Seard, and K. Wasserman, Effect of bilateral carotid-body resection on ventilatory control at rest and during exercise in man. New Engl. J. Med. 285, 1105–1111 (1971).PubMedGoogle Scholar
  11. 11.
    Y. Honda, Respiratory and circulatory activities in carotid body-resected humans. J. Appl. Physiol. 73, 1–8 (1992).PubMedGoogle Scholar
  12. 12.
    R. Lugliani, B. J. Whipp, and K. Wasserman, A role for the carotid body in cardiovascular control in man. Chest 63, 744–750 (1973).CrossRefPubMedGoogle Scholar
  13. 13.
    K. Wasserman, and B. J. Whipp, in: Morphology and Mechanisms of Chemoreceptors, edited by A. S. Paintal (V.P.C.I., Delhi, 1976), pp. 156–175.Google Scholar
  14. 14.
    T. L. Griffiths, L. C. Henson, and B. J. Whipp, Influence of peripheral chemoreceptors on the dynamics of the exercise hyperpnoea in man. J. Physiol. (Lond.) 380, 387–403 (1986).Google Scholar
  15. 15.
    K. Wasserman, B. J. Whipp, S. N. Koyal, and M. G. Cleary, Effect of carotid body resection on ventilatory and acid-base control during exercise. J. Appl. Physiol. 39, 354–358 (1975).PubMedGoogle Scholar
  16. 16.
    B. J. Whipp, Peripheral chemoreceptor control of the exercise hyperpnea in humans. Med. Sci. Sports Exer. 26, 337–347 (1994).Google Scholar
  17. 17.
    J. T. Davidson, B. J. Whipp, K. Wasserman, S. N. Koyal, and R. Lugliani, Role of the carotid bodies in the sensation of breathlessness during breath-holding. New Engl. J. Med. 290, 819–822 (1974).PubMedGoogle Scholar
  18. 18.
    P. M. Gross, B. J. Whipp, J. T. Davidson, S. N. Koyal, and K. Wasserman, Role of the carotid bodies in the heart rate response to breath holding in man. J. Appl. Physiol. 41, 336–340 (1976).PubMedGoogle Scholar
  19. 19.
    E. H. Vidruk, Hypoxia potentiates, oxygen attenuates deflation-induced reflex tracheal constriction. J. Appl. Physiol. 59, 941–946 (1985).PubMedGoogle Scholar

Copyright information

© Kluwer Academic/Plenum Publishers, New York 2004

Authors and Affiliations

  • Benjamin Winter
    • 1
  • Brian J. Whipp
    • 2
  1. 1.Garfield HospitalMonterey Park
  2. 2.Department of PhysiologySt George’s Hospital Medical SchoolLondonUK

Personalised recommendations