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The Control of Breathing in Clinical Brendan Caruana-Montaldo, MD; Kevin Gleeson, MD; and

Summary: The Control of Breathing in Clinical
Brendan Caruana-Montaldo, MD; Kevin Gleeson, MD; and
Clifford W. Zwillich, MD, FCCP
The control of breathing results from a complex interaction involving the respiratory centers,
which feed signals to a central control mechanism that, in turn, provides output to the effector
muscles. In this review, we describe the individual elements of this system, and what is known
about their function in man. We outline clinically relevant aspects of the integration of human
ventilatory control system, and describe altered function in response to special circumstances,
disorders, and medications. We emphasize the clinical relevance of this topic by employing case
presentations of active patients from our practice. (CHEST 2000; 117:205225)
Key words: carotid body; chemoreceptors; control of ventilation; pulmonary receptors
Abbreviations: CPAP continuous positive airway pressure; CSF cerebrospinal fluid; CSR Cheyne-Stokes
respiration; DRG dorsal respiratory group; [H ] hydrogen ion concentration; HCO3 bicarbonate;
MVV maximal voluntary ventilation; OSA obstructive sleep apnea; pHa arterial pH; PIIA postinspiration
inspiratory activity; PImax maximal inspiratory pressure; RAR rapidly adapting receptor; REM rapid eye
movement; Sao2 arterial oxygen saturation; SAR slowly adapting receptor; VC vital capacity; V e minute
ventilation; V o2 oxygen uptake; V /Q ventilation/perfusion; VRG ventral respiratory group; Vt tidal volume;
WOB work of breathing
This review is intended as an overview of human


Source: Akabas, Myles - Department of Physiology and Biophysics, Albert Einstein College of Medicine, Yeshiva University


Collections: Biology and Medicine