Effect of carotid body denervation on arousal response to hypoxia in sleeping dogs

Bowes, Glenn; Townsend, Edward R.; Kozar, L. F.; Bromley, S. M.; Phillipson, Eliot A.

doi:10.1152/jappl.1981.51.1.40

Cited by 100 publications

(59 citation statements)

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“…In support of this, Bowes et a/. have reported that bilateral vagal blockade delays the arousal response to rapidly developing hypoxemia in adult dogs (18). The third possibility is that arterial hypoxemia stimulates the carotid bodies, which produces an increase in heart rate and blood pressure and stimulates the carotid sinus baroreceptors, which causes arousal.…”

Section: Discussionmentioning

confidence: 90%

Influence of Carotid Denervation on the Arousal and Cardiopulmonary Response to Rapidly Developing Hypoxemia in Lambs

et al. 1989

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ABSTRACT. Experiments were done on five lambs to determine if carotid denervation influences the arousal and cardiopulmonary responses to rapidly developing hypoxemia during sleep. Each lamb was anesthetized and instrumented for recordings of electrocorticogram. electrooculo- The arousal response is an important protective response that may prevent severe hypoxemia and death during sleep (1). Hypoxemia may occur during sleep in individuals with chronic lung disease (e.g. cystic fibrosis [2], bronchopulmonary dysplasia [3], asthma [4]) and/or during central or obstructive apnea. The usual respiratory response to hypoxemia is an increase in ventilation, which tends to increase the alveolar and arterial oxygen tension. However, as the ventilatory response to hypoxemia is decreased during active sleep compared to quiet sleep in lambs (5) and calves (6) during obstructive apnea is usually preceded by arousal (7-lo), the arousal response may be the most important response to hypoxemia during sleep.Previous experiments on young lambs (5, 1 1-13) and calves (6) have demonstrated that arousal occurs from both quiet sleep and active sleep in response to alveolar hypoxia, but the mechanism remains unclear. The purpose of the present experiments was to investigate the effect of carotid-denemation on the arousal response from sleep to rapidly developing hypoxemia in young lambs. MATERIALS AND METHODSFive lambs ranging in age from 1 1 to 24 d were studied. Each lamb was separated from its ewe 3 to 7 d after birth and was housed in our laboratory in a Plexiglas cage with continuous access to milk (Lamb Milk Replacer, Land O'Lakes, Inc., Fort Dodge, IA). The lambs were among other lambs, fed and slept a d libitum, and soon became accustomed to the surroundings and laboratory personnel.Surgical preparation. Each lamb underwent one operation before the study. For surgery, each lamb was given atropine sulfate (0.2 mg/kg subcutaneously); anesthesia was induced by having the lamb breath 3 to 4% halothane in oxygen via a mask. The trachea was then intubated with a cuffed endotracheal tube; anesthesia was maintained by ventilating the lamb's lungs with 0.5-1.0% halothane in oxygen. An ECG, end-tidal carbon dioxide levels, and rectal temperature were monitored during surgery; body temperature was kept near 39°C with a heating pad, and end-tidal carbon dioxide levels were kept near 5% with a volumecycled ventilator.The operation was done when the lambs were between 7 and 2 1 d of age. A double-lumen fiberoptic catheter oximeter (Model U440 Opticath, Oximetrix, Inc., Mountain View, CA; 90% response to a step change in Sa02 within 5 s) was inserted to the thoracic aorta via a femoral artery for continuous measurement of arterial Hb oxygen saturation and blood pressure. Electrodes for the following recordings were also implanted: electrocorticogram (recorded from electrodes placed through burr holes to lie over the parietal cortex), electro-oculogram (recorded from electrodes placed at the inner and outer canthus of the right eye), nuchal...

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Section: Discussionmentioning

confidence: 90%

Influence of Carotid Denervation on the Arousal and Cardiopulmonary Response to Rapidly Developing Hypoxemia in Lambs

et al. 1989

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“…First, arousal is required for termination of apneic spells in adults with obstructive sleep apnea (13). Activity of the carotid bodies is required for arousal in adult dogs (20) and newborn lambs (2 1) subjected to progressive hypoxia. Thus, carotid body inactivity could well lead to failure of arousal and to apneas becoming prolonged and more likely to be associated with hypoxia and bradycardia.…”

Section: Discussionmentioning

confidence: 99%

The Natural History of the Appearance of Apnea of Prematurity

Barrington

Finer

1991

Pediatr Res

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ABSTRACT. Twenty healthy preterm infants of less than 34 wk gestation were studied with continuous recordings, commencing within 8 h of birth, for up to 1 wk of age to determine the usual time course of the appearance of apnea and to classify apnea types. Airway occlusion studies were also performed on a regular basis to determine whether apneic spells were preceded or followed by a reduction in central respiratory drive. Apneic spells of greater than 15 s duration accompanied by hypoxia or bradycardia occurred in all infants before 24 h of age. The frequency of apneic spells was highest in the first 24 h after birth with a mean frequency of 0.9/h and gradually reduced thereafter, falling to 0.2/h by 5 d of age ( p < 0.01). Apneic spells were more likely to be obstructive in the first 2 d of life than thereafter ( p < 0.05). Central apnea was proportionately significantly less frequent during this time period. Reduced respiratory drive, as demonstrated by airway occlusion pressures, was associated with more frequent apnea and was evident at the first occlusion study, which frequently preceded the first significant apnea. (Pediatr Res 29: 372-375,1991) Abbreviations SpOz, pulse oximeter-derived saturation Po.,, airway pressure 0.1 s after initiation of first occluded breath ANOVA, analysis of variance It is commonly stated that idiopathic apnea of prematurity develous after the first 24 to 72 h of life and amea that is noted early requires vigorous investigation (1). The factual basis of this statement is uncertain. Henderson-Smart (2) previously demonstrated that apnea (more than three spells of greater than 20 s duration) developed on the 1st or 2nd postnatal d in 77% of preterm infants. He appears to have used impedance monitoring only and it is uncertain whether any recordings were made for independent confirmation of apnea (3). Carlo et al. (4), utilizing 60-min recordings, showed that apneic spells of greater than 5 s duration occurred on d 1 in eight of 10 preterm infants without lung disease.There appears to be no published information regarding the usual frequency and nature of significant apneic spells in an unselected population of healthy newborn preterm infants who have undergone prolonged recordings.Our main objective was to ascertain the usual age of the appearance of apneic spells and the relative frequency of obstructive, mixed, and central apnea during the 1 st wk of life in preterm infants without respiratory disease. Our secondary objective was to describe the development of respiratory drive, by determining the postnatal progression of occlusion pressures, in infants with and without apnea. SUBJECTS AND METHODSTwenty infants of less than 34 wk gestation with birth weights above the 5th percentile for gestational age were studied. Infants were all born in the Royal Alexandra Hospitals and were entered into the study as soon after birth as possible. We entered consecutive infants who were clinically determined to be free of acute medical problems; in particular, they were without significan...

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“…In OSA, arousals are triggered by inspiratory effort against the occluded airway, 29 hypoxia, 30 and hypercapnia. 31 The stimuli for arousals following central apneas are not as well understood.…”

Section: Discussionmentioning

confidence: 99%

Differential Timing of Arousals in Obstructive and Central Sleep Apnea in Patients with Heart Failure

Simms

Brijbassi

Taranto‐Montemurro

et al. 2013

Journal of Clinical Sleep Medicine

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Effect of carotid body denervation on arousal response to hypoxia in sleeping dogs

Cited by 100 publications

References 0 publications

Influence of Carotid Denervation on the Arousal and Cardiopulmonary Response to Rapidly Developing Hypoxemia in Lambs

Influence of Carotid Denervation on the Arousal and Cardiopulmonary Response to Rapidly Developing Hypoxemia in Lambs

The Natural History of the Appearance of Apnea of Prematurity

Differential Timing of Arousals in Obstructive and Central Sleep Apnea in Patients with Heart Failure

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