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Ventilatory responses to progressive hypercapnia were analyzed in the normocapnic and hypercapnic obstructive sleep apnea patients (OSA). The rebreathing hypercapnic and hypoxic tests were performed using the computerized equipment (Lungtest, MES), according to Read's method. The ventilatory response to hypoxia was impaired in all OSA patients. Concerning the hypercapnic ventilatory response, there were no differences between the OSA patients with normal end-tidal PCO2 and controls. Nine moderately hypercapnic OSA patients showed a right shift with a normal slope of the regression curve describing the relationship between the end-tidal PCO2 and minute ventilation. In contrast, three severely hypercapnic OSA patients showed a right shift with a decreased slope of this regression curve. We conclude that awake OSA patients who developed hypercapnic ventilatory insufficiency showed an impaired hypercapnic defense reaction.
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Transient O2-dependent effects of CO2 on ventilation in the anesthetized mouse

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In this study we sought to determine the effects of background hyperoxia on the ventilatory response to hypercapnia. We addressed this issue by examining the temporal profile of the first minute transients of minute ventilation, and its frequency and tidal components, in response to 5% and 10% CO2 each co-applied with the natural (balanced with air) and hyperoxic (balanced with O2) levels of oxygen. The study was performed on the urethane-anesthetized, tracheostomized, spontaneously breathing mouse, placed in a flow-through body plethysmograph. We identified an early suppressant effect of CO2-in-O2 on breathing frequency. The frequency declined to 88.5 ±1.4% and 87.8 ±1.9% relative to the pre-test, baseline level for 5% and 10% CO2, respectively. There was a compensatory rise in tidal volume and no major change in the overall ventilation. In contrast, CO2-in-Air resulted in ventilatory stimulation caused in equal measure by frequency and tidal components. Thus, the inhibitory effect on breathing frequency of the CO2-in-O2 resulted from the O2 content in the mixture and had the temporal characteristics consistent with carotid body function. In conclusion, transient O2-dependent effects can bear on the nascent hypercapnic ventilatory response. The complexity of the O2-CO2 interaction regarding the breathing pattern components should be taken into account while designing the optimal conditions for a hypercapnic test.
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