CO2 chemosensitivity
Technical procedure for the CO2 rebreathing test
Abstract
Patients with chronic hypercapnia should be suspected to have a blunted respiratory drive when their lung function and/or respiratory muscle strength are normal or slightly altered. Various tests are available for its evaluation. The respiratory response to hypercapnia is a simple and non-invasive test evaluating the chemical respiratory drive. However, to obtain representative results, a procedure must be carefully followed. The CO2 rebreathing response is measured by the occlusion pressure developed at 0.1 second (P0.1). The slope (ᐃP0.1/ᐃPetCO2, cmH2O/mmHg) reflects the chemosensitivity to changes in CO2.
References
Arce SC, De Vito EL. More Breathing, Less Fitness: Lessons from Exercise Physiology in Chronic Obstructive Pulmonary Disease-Heart Failure Overlap. Am J Respir Crit Care Med. 2017;196(10):1233–4.
Bégin P, Mathieu J, Almirall J, Grassino A. Relationship between chronic hypercapnia and inspiratory-muscle weakness in myotonic dystrophy. Am J Respir Crit Care Med. 1997;156(1):133–9.
Sorli J, Grassino A, Lorange G, Milic-Emili J. Control of breathing in patients with chronic obstructive lung disease. Clin Sci Mol Med. 1978;54(3):295–304.
Fahey PJ, Hyde RW. “Won’t breathe” vs “can’t breathe”. Detection of depressed ventilatory drive in patients with obstructive pulmonary disease. Chest. 1983;84(1):19–25.
De Vito EL. [Causes of CO2 retention in patients with chronic obstructive lung disease]. Medicina. 1993;53(4):350–6.
De Vito EL, Monteiro SG, Aruj PK. Blunted Hypercapnic Respiratory Drive Response in Subjects With Late-Onset Pompe Disease. Respir Care. 2016;61(7):930–5.
Aruj PK, Monteiro SG, De Vito EL. [Analysis of factors associated with chronic hypercapnia in patients with myotonic dystrophy]. Medicina. 2013;73(6):529–34.
Burki NK. Measurements of ventilatory regulation. Clin Chest Med. 1989;10(2):215–26.
Whitelaw WA, Derenne JP, Milic-Emili J. Occlusion pressure as a measure of respiratory center output in conscious man. Respir Physiol. 1975;23(2):181–99.
Montes de Oca M, Celli BR. Mouth occlusion pressure, CO2 response and hypercapnia in severe chronic obstructive pulmonary disease. Eur Respir J. 1998;12(3):666–71.
Burki NK, Mitchell LK, Chaudhary BA, Zechman FW. Measurement of mouth occlusion pressure as an index of respiratory centre output in man. Clin Sci Mol Med. 1977;53(2):117–23.
Gorini M, Spinelli A, Ginanni R, Duranti R, Gigliotti F, Arcangeli P, et al. Neural respiratory drive and neuromuscular coupling during CO2 rebreathing in patients with chronic interstitial lung disease. Chest. 1989;96(4):824–30.
Altose MD, McCauley WC, Kelsen SG, Cherniack NS. Effects of hypercapnia and inspiratory flow-resistive loading on respiratory activity in chronic airways obstruction. J Clin Invest. 1977;59(3):500–7.
