Abstract
Chronic hypercapnia has been associated with a change in the ventilatory responsiveness to inspired CO2 (CHAPIN et al., and SCHAEFER et al. [1963]). States of severe chronic hypercapnia in man are usually associated with disease of the ventilatory apparatus, so that it is difficult to distinguish the limitations in ventilatory responsiveness imposed by abnormal mechanical function of the chest bellows or lungs and those imposed by changes in sensitivity to the CO2 or H+ stimulus (ALEXANDER et al. [1955], and CHERNIAK and SNIDAL [1956]). In this study two aspects of the ventilatory responsiveness to chronic hypercapnia were investigated: (1) the “normal” or predicted HCO −3 Pco2 relationship in individuals with chronic hypercapnia who are in normal electrolyte balance; and (2) the effect of chloride depletion, potassium chloride replacement, and ammonium chloride acidosis on the ventilatory responsiveness to inspired CO2. The subjects selected for study were patients with alveolar hypoventilation from long-standing chest-wall disease and included three men aged 41 to 58 years with cardiorespiratory failure secondary to kyposcoliosis and one woman aged 20 with alveolar hypoventilation secondary to skeletal muscle disease. Their level of alveolar hypoventilation was stable. The experimental design consisted of three study periods; (1) a five- to eight-day control period during which dietary sodium chloride remained restricted, as it had been for many months prior to their entering the study: (2) a five-day period of potassium chloride administration (100 mm/day) orally; and (3) a five-day period during which ammonium chloride (100 mm/day) was administered orally.
Work supported in part by USPHS Grant HE-05741 and CA-11096.
Career Invesgatorship of the Health Research Council of the City of New York(I-182)
Career Invesgatorship of the Health Research Council of the City of New York(I-590)
Work supported in part by USPHS Grant CA-11096.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Bibliography
Alexander, J. K., West, J. R., Wood, J. A., and Richards, D. W., “Analysis of the respiratory responses to carbon dioxide inhalation in varying clinical states of hypercapnia, anoxia and acid-base derangement.” J. Clin. Invest. 34:511 (1955).
Brackett, N. C., Wingo, C. F., Muren, O., and Solano, J. T., “Acid-base response to chronic hypercapnia in man.” N. Eng. J. Med. 280:124 (1969).
Chapin, J. L., Otis, A. B., and Rahn, H., “Changes in sensitivity of the respiratory center in man after prolonged exposure to 3% CO2.” U.S. Air Force Wright Field Development Technical Report WADC No. 55–357.
Cherniack, R. M., and Snidal, D. P., “The effect of obstruction to breathing on the ventilatory response to CO2 inhalation.” J. Clin. Invest. 35:1286 (1956).
Cohen, J., and Schwartz, W. B., “Evaluation of acid-base equilibrium in pulmonary insufficiency (Editorial).” Am. J. Med. 41:163 (1966).
Engel, K., Dell, R. B., Rahill, W. J., Denning, R., and Winters, R. W., “Quantitative displacement of acid-base equilibrium in chronic respiratory acidosis.” J. Appl. Physiol. 24:288 (1968).
Fencl, V., Miller, J. B., and Pappenheimer, J. R., “Studies on the respiratory response to disturbances of acid-base balance, with deductions concerning the ionic composition of cerebral interstitial fluid.” Am. J. Physiol. 210:459 (1966).
Goldring, R. M., Turino, G. M., and Heinemann, H. O., “Respiratory-renal adjustments in chronic hypercapnia in man: Extracellular bicarbonate concentration and the regulation of ventilation.” Am. J. Med. 51:772 (1971).
Leusen, I. R. Aspects of acid-base balance between blood and cerebrospinal fluid. Cerebrospinal fluid and the regulation of ventilation. (C. M. Brooks, F. F. Kao, and B. B. Lloyd, eds.) Oxford: Blackwell (1965).
Loeschcke, H. H. A concept of the role of intracranial chemosensitivity in respiratory control. Cerebrospinal fluid and the regulation of ventilation. (C. M. Brooks, F. F. Kao, and B. B. Lloyd, eds.) Oxford: Blackwell (1965).
Luke, R. G., Warren, Y., Kashgarian, M., Levitan, H., “Effects of chloride restriction and depletion on acid-base balance and chloride conservation in the rat.” Clin. Sci. 38:385 (1970).
Rector, F. C., Jr., Carter, N. W., and Seldin, W., “The mechanism of bicarbonate reabsorption in the proximal and distal tubules of the kidney.” J. Clin. Invest. 44:278 (1965).
Refsum, H. E., “Acid-base status in patients with chronic hypercapnia and hypoxemia.” Clin. Sci. 27:407 (1964).
Robin, E. D., “Abnormalities of acid-base regulation in chronic pulmonary disease with special reference to hypercapnia and extracellular alkalosis.” N. Eng. J. Med. 268:917 (1963).
Sapir, D. G., Levine, D. Z., and Schwartz, W. B., “The effects of chronic hypokalemia on electrolyte and acid-base equilibrium: An examination of normocapneic hypoxemia and of the influence of hypoxemia on the adaptation to chronic hypercapnia.” J. Clin. Invest. 46:369 (1967).
Schaefer, K. E., Hastings, B. J., Carey, C. R., and Nichols, G., Jr., “Respiratory acclimatization to carbon dioxide.” J. Appl. Physiol. 18:1071 (1963).
Schwartz, W. B., Hays, R. M., Polak, A., and Haynie, G. D., “Effects of chronic hypercapnia on electrolyte and acid-base equilibrium. II. Recovery with special reference to influence of chloride intake.” J. Clin. Invest. 40:1238 (1961).
Schwartz, W. B., Brackett, N. C., Jr., and Cohen, J., “The response of extracellular hydrogen ion concentration to graded degrees of chronic hypercapnia, the physiologic limits of the defense of pH.” J. Clin. Invest. 41:291 (1965).
Scott, R. W., “Observations on the pathologic physiology of chronic pulmonary emphysema.” Arch. Int. Med. 26:544 (1920).
Turino, G. M., Goldring, R. M., and Heinemann, H. O., “Water, electrolytes and acid-base relationships in chronic cor pulmonale.” Prog. Cardiovascular Dis. 12:467 (1970).
Van Ypersele de Strihou, C., Brasseur, B., and Deconinck, J., “‘Carbon dioxide response curve’ for chronic hypercapnia in man.” N. Eng. J. Med. 275:117 (1966).
Winterstein, H., “Chemical control of pulmonary ventilation. III. The ‘reaction theory’ of respiratory control.” N. Eng. J. Med. 255: 331 (1956).
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1974 Springer-Verlag New York Inc.
About this paper
Cite this paper
Turino, G.M., Goldring, R.M., Heinemann, H.O. (1974). The Extracellular Bicarbonate Concentration and the Regulation of Ventilation in Chronic Hypercapnia in Man. In: Nahas, G., Schaefer, K.E. (eds) Carbon Dioxide and Metabolic Regulations. Topics In Environmental Physiology And Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-9831-1_26
Download citation
DOI: https://doi.org/10.1007/978-1-4612-9831-1_26
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4612-9833-5
Online ISBN: 978-1-4612-9831-1
eBook Packages: Springer Book Archive