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Biomedical subjects

M S Meah

Publications and source records attributed to M S Meah.

3 recordsLinked to original sources

Post-hyperventilation apnoea in conscious humans.

1. In nine normal subjects, analysis was performed of the number, length and location of apnoeic pauses during 20 min of recovery following voluntary overbreathing (VHV). Four different rates of recovery of end-tidal PCO2 (PET,CO2), studied in randomized order, were induced by overbreathing to 15 or 25 mmHg, each for 3 or 6 min. Subjects breathed mildly hyperoxic gas mixtures (inspired PO2 approximately 250 mmHg) to and fro into an open circuit via a mouthpiece and pneumotachograph. 2. Apnoeic pauses rarely occurred immediately after the end of VHV but gradually increased in number and length. When averaged across all subjects and protocols, the largest pauses occurred 2.0 +/- 0.3 min (S.D.; range 1.6-2.4 min) after the end of VHV. Based on a definition of apnoea as expiratory time greater than 6 s, apnoeas occurred between mean times of 0.8 and 5.6 min after the end of VHV, the end of this period being associated with a mean PET,CO2 value of 36.4 mmHg, which was below the initial mean resting value of 39.8 mmHg. 3. Within this apnoeic period, 80% of experiments produced apnoeas of less than 10 s duration, 61% of between 10 and 20 s duration and 42% of between 20 and 30 s duration. Only one out of nine subjects consistently failed to show apnoeas. 4. The range of lengths of individual apnoeas and the number per minute were independent of the length and level of VHV and were not significantly different between the four protocols. 5. The number and length of apnoeas did not change in repeated runs in each subject. We were not able to confirm previous reports that apnoeas occurred more frequently in subjects familiar with the experiment. 6. These results reconciled previous studies showing either apnoea or hyperpnoea following voluntary overbreathing in conscious humans. They showed an initial period of heightened breathing lasting about a minute with few apnoeas, consistent with 'after-discharge'. Beyond that, apnoeas occurred as an 'all-or-nothing' phenomenon as long as PET,CO2 was on average less than 3.4 mmHg below resting PET,CO2. The occurrence and length of apnoeas was consistent in individual subjects with no evidence of a learning effect.

Adult↗

Respiration during exercise in conscious laryngectomized humans.

We compared respiratory patterning at rest and during steady cycle exercise at work rates of 30, 60, and 90 W in 7 male chronically laryngectomized subjects and 13 normal controls. Breathing was measured with a pneumotachograph and end-tidal PCO2 by mass spectrometer. Inspired air was humidified and enriched to 35% O2. Peak flow, volume, and times for the inspiratory and expiratory half cycles, time for expiratory flow, minute ventilation, and mean inspiratory flow were computer averaged over at least 40 breaths at rest and during the last 2 min of 5-min periods at each work rate. During the transition from rest to exercise and with increasing work rate in both groups, there was an increase in respiratory rate and depth with selective and progressive shortening of expiratory time; these responses were not significantly different between the two groups, but there was a suggestion that respiratory "drive" as quantitated by mean inspiratory flow may limit in the laryngectomized subjects at high work rates. Time for expiratory flow increased on transition from rest to exercise and then decreased in both groups as the work rate increased; it was shorter in the laryngectomy than control group at all levels. In the laryngectomized subjects there was significantly more breath-by-breath scatter in some variables at rest, but there was no difference during exercise. It is concluded that chronic removal of the larynx and upper airways in mildly hyperoxic conscious humans has only subtle and, therefore, functionally insignificant effects on breathing during moderate exercise. Evidence is provided that the upper airways can modulate expiratory flow but not expiratory time during exercise.

Carbon Dioxide↗

Controlled study of respiratory responses during prolonged measurement in patients with chronic hyperventilation.

The respiratory responses of 17 patients with chronic hyperventilation but without demonstrable organic disease (group H) to various manoeuvres were compared with those of 21 healthy controls (group C). The responses were tested according to a 60 min protocol in which periods of rest were replaced by exercise, voluntary hyperventilation (VHV), reading, and CO2 inhalation. 5 patients with severe resting hypocapnia were investigated overnight during sleep. Chronic hyperventilation was of two types--persistent or provoked by exercise or VHV. It was due to modest increases in tidal volume and respiratory frequency but was generally not conspicuous. End-tidal PCO2 levels were gradually corrected to near normal during sleep but not by inhalation of CO2.

Adult↗