CO2 retention in lung disease; could there be a pre-existing difference in respiratory physiology |
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| Authors: | Helen M. A. Dunroy Lewis Adams Douglas R. Corfield Mary J. Morrell |
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| Affiliation: | a Department of Respiratory Medicine, National Heart and Lung Institute, Imperial College School of Medicine, Charing Cross Campus, St. Dunstans Road, London W6 8RP, UK;b Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK;c School of Physiotherapy and Exercise Science, Griffith University, Gold Coast Campus, PMB 50 Gold Coast Mail Centre, Gold Coast, Qld. 9726, Australia |
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| Abstract: | Some patients with lung disease retain CO2, while others with similar lung function do not. This could be explained if CO2 retainers had a pre-existing low hypercapnic ventilatory response (HCVR) and, from this, a tendency to retain CO2. To test if such a phenomenon exists in healthy people, we determined the change in end-tidal PCO2 (ΔPETCO2) produced by the addition of a dead-space (DS), during wakefulness and sleep, and related this to the HCVR measured awake. The group mean (n=14) HCVR slope was 2.2±1.1 (S.D.) L min−1 mmHg−1. The ΔPETCO2 with the application of DS was 1.6±1.6 mmHg awake and 2.6±2.2 mmHg asleep. During wakefulness the ?PETCO2 with DS did not correlate with the HCVR slope. However, during sleep, four subjects had a marked increase in the ΔPETCO2 (3.7, 4.3, 6.2, 8.0 mmHg) and a relatively low HCVR (slope 1.5, 1.7, 1.5, 1.7 L min−1 mmHg−1, respectively). We speculate that such individuals, should they develop lung disease, may be predisposed to retain CO2. |
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| Keywords: | Carbon dioxide, retention, lung disease Control of breathing, hypercapnic ventilatory response Dead space, added external, CO2 retention Mammals, humans Sleep |
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