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By J. F. Nunn

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Example text

According to the usual convention, such a relationship should be drawn with ventilation on the X axis and P c o 2 on the Y axis (as in Figure 48), but for convenience the relationship is also included in Figure 7 as a dotted curve which is a segment of a rectangular hyperbola. As ventilation changes, for example in response to 31 CONTROL OF BREATHING hypoxic drive, the arterial P c o 2 changes according to this relationship and the point representing the patient migrates along the dotted curve to the left.

For example, thought has been given to the possibility that the chemoreceptor cells might be uniquely sensitive to a fall in intracellular pH. It would then be possible to postulate their stimulation by a rise in P c o 2 (which lowers intracellular pH by diffusion of carbon dioxide into the cell), or by reduction of P o 2 (which, if sufficiently severe, would cause the cell to utilize anaerobic metabolic pathways). Hypoperfusion and poisoning of cytochrome a 3 would also prevent or diminish aerobic metabolism, and could cause intracellular acidosis from the production of lactic acid.

F. F. or by renal compensation. F. F. F. is altered by pathological factors, the pH is changed and ventilatory disturbances follow. Froman and Crampton-Smith (1966) described three patients who hyperventilated after intracranial haemorrhages. F. F. In a later communication, Froman (1966) reported correction of hyperventilation by intrathecal administration of 3 - 5 mEq. of bicarbonate. There are considerable difficulties in determining the precise location of the medullary chemoreceptors in relation to the surface of the medulla and also in defining the relative importance of the factors which govern the pH in their vicinity.

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