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Control of Breathing During Assisted Mechanical Ventilation

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine 1998

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1998))

Abstract

The respiratory control system consists of a motor arm which executes the act of breathing, a contol center located in the medulla and a number of mechanisms that convey information to the control center [1, 2]. Based on the information received, the control center activates spinal motor neurons subserving respiratory muscles, with an intensity and rate that varies substantially between breaths. The activity of the spinal motor neurons is conveyed, via peripheral nerves, to respiratory muscles, which contract and generate pressure (Pmus). Pmus is dissipated to overcome the resistance and elastance of the respiratory system (inertia is assumed to be negligible) and this combination determines volume-time profile and, thus, ventilation. Volume-time profile affects Pmus via force-length and force-velocity relationships of the respiratory muscles (mechanical feedback), whereas it modifies the activity of spinal motor neurons and the control center via afferents from various receptors located in the airways, chest wall or respiratory muscles (reflex feedback). Input generated from other sources (e.g., behavioral, temperature, postural) may also modify the function of the control center. On the other hand, ventilation and gas exchange properties of the lung determine arterial blood gases (PaO2, PaCO2), which, in turn, affect the activity of the control center, via peripheral and central chemoreceptors (chemical feedback). This briefly described complex system may be influenced at any level by various disease states as well as by therapeutic interventions.

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Authors
  1. D. Georgopoulos
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Editors and Affiliations

  1. Department of Intensive Care, Erasme Hospital, Free University of Brussels, Route de Lennik 808, B-1070, Brussels, Belgium

    Jean-Louis Vincent (Clinical Director) (Clinical Director)

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© 1998 Springer-Verlag Berlin Heidelberg

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Georgopoulos, D. (1998). Control of Breathing During Assisted Mechanical Ventilation. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine 1998. Yearbook of Intensive Care and Emergency Medicine, vol 1998. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72038-3_34

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  • DOI: https://doi.org/10.1007/978-3-642-72038-3_34

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-63798-1

  • Online ISBN: 978-3-642-72038-3

  • eBook Packages: Springer Book Archive

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