The effect of excess of carbon dioxide and of want of oxygen upon the respiration and the circulation

Hill, Leonard; Flack, M R

doi:10.1113/jphysiol.1908.sp001258

Cited by 113 publications

(46 citation statements)

References 3 publications

(4 reference statements)

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“…As a group, HLT subjects would appear to behave no differently from matched control subjects in ability to hold their breath or in the time course of improvement in air hunger following the end of breath-holding; however, two of the four HLT subjects reported full relief only after a delay longer than that reported by all five control subjects. It is known that resumption of breathing at the end of breath-holding is accompanied by rapid relief of discomfort even when any improvement in blood gas status is prevented (Hill & Flack, 1908;Fowler, 1954); this has led to the view that afferent feedback from mechanoreceptors within the respiratory system provides the neural basis for such relief. All HLT subjects studied reported some relief of respiratory discomfort within 2 s of breath-hold break point (i.e.…”

Section: Discussionmentioning

confidence: 99%

Ventilatory relief of the sensation of the urge to breathe in humans: are pulmonary receptors important?

Harty

Mummery

Adams

et al. 1996

The Journal of Physiology

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1. The sensation of an urge to breathe (air hunger) associated with a fixed level of hypercapnia is reduced when ventilation increases. The aim of the present study was to investigate whether pulmonary receptors are important in this mechanism. 2. Five heart-lung transplant (HLT) subjects and five control subjects were studied during periods of mechanical and spontaneous ventilation. End-tidal PCO, (PET,Co2) was increased by altering the level of inspired C02. Throughout, subjects rated sensations of air hunger. Air hunger was also monitored during and immediately following maximal periods of breath-holding. 3. When the level of mechanical ventilation was fixed, both groups experienced a high degree of air hunger when PET,co, was increased by about 10 mmHg. At similar levels of hypercapnia, both groups derived relief from approximately twofold increases in tidal volume, although relief was slightly less effective in HLT subjects. This was reversible, with decreases in the level of mechanical ventilation rapidly giving rise to increased ratings of air hunger. 4. With breath-holding, all subjects obtained some respiratory relief within 2 s of the break point; there was no significant difference between the groups. 5. The results suggest that sensations of an urge to breathe induced by hypercapnia can be modulated by changes in tidal volume in the presumed absence of afferent information from the lung.

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Section: Discussionmentioning

confidence: 99%

Ventilatory relief of the sensation of the urge to breathe in humans: are pulmonary receptors important?

Harty

Mummery

Adams

et al. 1996

The Journal of Physiology

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“…Mechanoreceptors in the lungs, airways, and chest wall provide afferent information about achieved pulmonary ventilation and can inhibit (relieve) air hunger/unsatisfied inspiration (98)(99)(100)(101)(102)(103). In animal models of emphysema, pulmonary stretch receptor discharge is decreased (104).…”

Section: Qualities Of Dyspneamentioning

confidence: 99%

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

Parshall¹,

Schwartzstein²,

Adams³

et al. 2012

Am J Respir Crit Care Med

1,475

1,328

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“…The use of voluntary breath hold as a probe to gain insight into the physiological mechanisms of shortness of breath dates to at least a century ago (Hill and Flack 1908;Flume et al 1994;Nishino et al 1996). Breath holds are normally terminated due to a perception of the need for air ('air hunger') that becomes intolerable; hence, breath hold time (taken conventionally as the time during which there is no airflow at the airway opening) has been used as a measure of air hunger tolerance (Lin et al 1974).…”

Section: Introductionmentioning

confidence: 99%

The air hunger response of four elite breath-hold divers

Binks

Vovk²,

Ferrigno

et al. 2007

Respiratory Physiology & Neurobiology

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Normal subjects terminate breath-holds due to intolerable 'air hunger'. We hypothesize that competitive breath-hold divers might have increased tolerance of air hunger. We tested the air hunger (AH) response of 4 divers who could hold their breath for 6 -9 min. Tidal volume and respiratory rate were controlled by mechanical ventilation (ventilation ≈ 0.16 L·min −1 ·kg −1 ). AH was induced by raising P CO 2 and rated using a visual analog scale whose maximum was defined as intolerable. SpO 2 was maintained at >97%. Three divers reported the same uncomfortable urge to breathe as normal subjects; the slopes of their responses were within normal range. Both resting CO 2 and AH threshold were shifted to higher CO 2 in some divers. Diver 3 was unique amongst neurologically intact subjects we have studied: he denied feeling an urge to breathe, and denied discomfort. We conclude that elite divers' strategies to tolerate intense air hunger are a minor factor in their ability to tolerate long breath holds.

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The effect of excess of carbon dioxide and of want of oxygen upon the respiration and the circulation

Cited by 113 publications

References 3 publications

Ventilatory relief of the sensation of the urge to breathe in humans: are pulmonary receptors important?

Ventilatory relief of the sensation of the urge to breathe in humans: are pulmonary receptors important?

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

The air hunger response of four elite breath-hold divers

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