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2014 ; 44
(2
): 495-512
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Pathophysiology of human ventilatory control
#MMPMID24925922
Dempsey JA
; Smith CA
Eur Respir J
2014[Aug]; 44
(2
): 495-512
PMID24925922
show ga
We review the substantial recent progress made in understanding the underlying
mechanisms controlling breathing and the applicability of these findings to
selected human diseases. Emphasis is placed on the sites of central respiratory
rhythm and pattern generation as well as newly described functions of the carotid
chemoreceptors, the integrative nature of the central chemoreceptors, and the
interaction between peripheral and central chemoreception. Recent findings that
support critical contributions from cortical central command and muscle afferent
feedback to exercise hyperpnoea are also reviewed. These basic principles, and
the evidence supporting chemoreceptor and ventilatory control system plasticity
during and following constant and intermittent hypoxaemia and stagnant hypoxia,
are applied to: 1) the pathogenesis, consequences and treatment of obstructive
sleep apnoea; and 2) exercise hyperpnoea and its control and limitations with
ageing, chronic obstructive pulmonary disease and congestive heart failure.
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