Influence of sleep state on CO2 responsiveness. A study of the unloaded respiratory pump in humans.
Influence of sleep state on CO2 responsiveness. A study of the unloaded respiratory pump in humans.
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睡眠状态对 CO2 反应性的影响。
DOI：
10.1164/ajrccm/144.5.1125
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发表时间：
1991
期刊：
影响因子：
--
通讯作者：
Hubmayr,RD
中科院分区：
文献类型：
--
作者：
Ingrassia3rd,TS;Nelson,SB;Harris,CD;Hubmayr,RD
本文测定了8例呼吸衰竭患者在清醒、非快动眼睡眠（NREM）和快动眼睡眠（REM）时的CO2补充阈（RT）。因为在RT测量期间肺是机械通气的，所以我们能够定义唤醒状态对无负荷呼吸系统的化学反应性的影响。每例患者的呼吸机设置保持不变，确保在所有测量期间呼吸控制器的机械感受器输入保持不变。RT从放松清醒时的38±6 mm Hg增加到NREM睡眠时的42±8 mm Hg（p~ 0.01），与睡眠期间化学反应减弱一致。在五个受试者中，我们也能够在REM睡眠期间测量RT。其中4人的REM RT超过了清醒测量值至少3 mm Hg。其余患者在两种睡眠状态下RT均无明显变化。我们的结论是，在人类中，觉醒刺激的丧失有助于睡眠诱导的高碳酸血症。AM修订版DIS 1991; 144：1125-1129
Wemeasured the ventilatory recruitment threshold for CO2 (RT) during wakefulness, non rapid eye movement sleep (NREM), and rapid eye movement sleep (REM) in eight patients with respiratory failure. Because the lungs were mechanically ventilated during the RT measurements, we were able to define the effects of arousal state on the chemoresponsiveness of the unloaded respiratory system. Ventilator settings were held constant In each patient, assuring that mechanoreceptor input to the respiratory controller remained the same during all measurements. RTIncreased from 38±6 mm Hg during relaxed wakefulness to 42±8 mm Hg during NREMsleep (p~ 0.01), consistent with a blunting of chemoresponslveness during sleep. In five subjects we were able to measure RT during REMsleep also. In four of them, REM RT exceeded the wakefulness measure· ment by at least 3 mm Hg. The remaining patient showed no demonstrable changes in RT during either sleep state. Weconclude that the loss of a wakefulness stimulus contributes to sleep-Induced hypercarbla In humans. AM REV RESPIR DIS 1991; 144: 1125-1129