Abstract
Neurological aberrations occurring in patients with advanced chronic obstructive pulmonary disease (COPD) and in patients with hepatic encephalopathy have many similarities. These similarities include changes in the level of consciousness varying from restlessness to coma1, 2 and alterations in neuromuscular tone, including dyskinetic movements3, 4. There may be a common biochemical derangement in these diseases, for Valero et al.5 have demonstrated that elevations of both cerebrospinal fluid (CSF) and arterial blood ammonia levels to concentrations equivalent to those seen in hepatic insufficiency can occur in COPD.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Pitt B., Alkalay, I., Sweet, R. and Stein, M.: Respiratory failure with focal neurological signs. Arch. Int. Med. 115:714–717, 1965.
Comroe, J.H., Bahson, E.R. and Coates, Jr., E.O.: Mental changes occurring in chronically anoxemic patients during oxygen therapy. J.A.M.A. 143: 1044–1048, 1950.
Davidson, E.A. and Solomons, P.: The differentiation of delirium tremens from impending hepatic coma. J. Mental Sci. 104:326–333, 1958.
Austen, F.K., Carmichael, M.D. and Adams, R.D.: Neurologic manifestations of chronic pulmonary insufficiency. New Eng. J. Med. 257:579–590, 1957.
Valero, A., Alroy, G., Eisenkraft, B. and Itskovitch, J.: Ammonia metabolism in chronic obstructive pulmonary disease with special reference to congestive right ventricular failure. Thorax 29:703–709, 1974.
Posner, J.B. and Plum, F.: The toxic effects of carbon dioxide and acetazolamide in hepatic encephalopathy. J. Clin. Invest. 39:1246–1258, 1960.
Jones, N.L.: Pulmonary gas exchange during exercise in patients with chronic airway obstruction. Clin. Sci. 31: 39–50, 1966.
Posner, J.B. and Plum, F.: The toxic effects of carbon dioxide and acetazolamide in hepatic encephalopathy. J. Clin. Invest. 39:1246–1258, 1960.
Stanley, N.N., Salisbury, B.G., McHenry, Jr., L.D. and Cherniack, N.S.: Effect of liver failure on the response of ventilation and cerebral circulation to carbon dioxide in man and in the goat. Clin. Sci. MOl. Med. 49:157–169, 1975.
Tenney, S.M.: Ventilatory response to carbon dioxide in pulmonary emphysema. J. Appl. Physiol. 6:477–484, 1954.
Agrest, A., de Bercovich, C. and Navon, S.: Ammonia and adenosine-triphosphate in the central nervous system of rats with dyspnoea and chronic hypercapnia. Clin. Sci. 28: 401–405, 1965.
Marbach, E.P. and Weil, M.D.: Rapid enzymatic measurement of blood lactate and pyruvate. Clin. Chem. 13:314–325, 1967.
Noll, F.: L-Lactate determination with LDH, GPT and NAD. In: Methods of Enzymatic Analysis, Vol. 3, edited by H. Bergmeyer. New York: Academic Press, 1974, pp. 1475-1479.
Welshman, S.G. and McCambridge, H.: The estimation of citrate in serum and urine using a citrate lyase technique. Clin. Chim. Acta 46:243–246, 1973.
Huang, Y-Z.: A new method for the assay of glutaminase activity: direct measurement of product formation by an ammonia electrode. Anal. Biochem. 61:464–470, 1974.
Adams, R.E.: Determination of amino acid profiles in biological samples by gas chromatography. J. Chromatography 95:189–212, 1974.
Renzetti, A.D., Jr., Harris, B.A. and Bowen, J.F.: Influence of ammonia on respiration. J. Appl. Physiol. 16:703–708, 1961.
Cherniack, R.M.: Work of breathing and the ventilatory response to CO2. In: Handbook of Physiology: Respiration, Vol. II, edited by W.O.Fenn and H.Rahn. American Physiological Society,Washington, D.C., 1965, pp. 1469–
Hindfelt, B. and Siesjo, B.K.: The effect of ammonia on the energy metabolism of the rat brain. Life Sciences : 9 1021–1028, 1970.
McKhann, G.M. and Tower, D.B.: Ammonia toxicity and cerebral oxidative metabolism. Am. J. Physiol. 200:420–424, 1961.
Katunuma, N., Okada, M. and Nishii, Y.: Regulation of the urea cycle and TCA cycle by ammonia. In: Advances in Enzyme Regulation. Vol. 4, edited by G. Wever. New York: Pergamon Press, 1966, pp. 317–320.
Toleikis, J.R., Wang, L.D.L. and Boyarsky, L.L.: Effect of amino acids on the activity of medullary respiratory neurons. Fed. Proc. 35:719, 1976.
Weyne, J., Van Leuven, F. and Leusen, I.: Brain organic acids during hypercapnia. Bull. Europ. Physiopath. Resp. 12: 285–291, 1976.
Tews, J.K., Carter, S.H., Roa, P.D. and Stone, W.E.: Free amino acids and related compounds in dog brain: post-mortemand anoxic changes, effects of ammonium chloride infusion and levels during seizures induced by picrotoxin and by pentylenetetrazol. J. Neurochem. 10:641–653, 1963.
Von Euler, U.S., Liljestrand, G. and Zotterman, Y.: Excitation mechanism of chemoreceptors of the carotid body. Scand. Arch. Physiol. 83:132–152, 1
Eldridge, F.L.: The importance of timing on the respiratory effects of intermittent carotid body chemoreceptor stimulation. J. Physiol. 222:319–333, 1972.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1978 Plenum Press, New York
About this chapter
Cite this chapter
Berkman, R.A., Meyer, K.T., Rosenberg, A.G., Dutton, R.E. (1978). Depressant Effect of Ammonia on the Ventilatory Response to Hypoxia and Hypercapnia. In: Fitzgerald, R.S., Gautier, H., Lahiri, S. (eds) The Regulation of Respiration During Sleep and Anesthesia. Advances in Experimental Medicine and Biology, vol 99. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-4009-6_24
Download citation
DOI: https://doi.org/10.1007/978-1-4613-4009-6_24
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-4011-9
Online ISBN: 978-1-4613-4009-6
eBook Packages: Springer Book Archive