Ventilatory control in two asthmatics resuscitated from respiratory arrest.
Two female patients revived from fulminant attacks of asthma are described. Ventilatory responses to asphyxia in these patients were 0.70 +/- 0.10 l min-1 % SaO2-1 and 0.64 +/- 0.21 l min-1 % SaO2-1 (mean +/- SEM), respectively. These values were significantly less than the responses of seven normal female subjects (1.54 +/- 0.11 l min-1 % SaO2-1 mean +/- SEM; p less than 0.01). Ventilatory responses to hypercapnia of the two patients were in the low normal range. Dopamine-receptor blockade with prochlorperazine significantly increased the ventilatory response to asphyxia in normal subjects (p less than 0.05 or less for each subject) but did not alter the depressed responses in the asthmatic patients. In one patient, naloxone in a dose of 400 micrograms reversed the decreased ventilatory responsiveness; the response to asphyxia was increased from 0.72 l min-1 % SaO-1 to 1.80 l min-1 % SaO2-1 (p less than 0.01) and the response to hypercapnia was increased from 0.90 l min-1 mmHg-1 to 4.80 l min-1 mmHg-1 (p less than 0.01). Naloxone had no effect in the second asthmatic patient nor in five normal subjects. Defective chemoreceptor responses to chemical stimuli may play a role in sudden death from asthma; endogenous opioids may mediate this disorder of ventilatory control.
D000328:Adult; D001237:Asphyxia / Q000503:physiopathology; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004723:Endorphins / Q000502:physiology; D005260:Female; D006339:Heart Rate; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009270:Naloxone / Q000008:administration & dosage / Q000494:pharmacology; D011346:Prochlorperazine / Q000008:administration & dosage / Q000494:pharmacology; D012123:Pulmonary Ventilation / Q000187:drug effects; D011954:Receptors, Dopamine / Q000187:drug effects; D012131:Respiratory Insufficiency / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D012151:Resuscitation; D013147:Spirometry
D001993:Bronchodilator Agents; D004723:Endorphins; D011954:Receptors, Dopamine; D009270:Naloxone; D011346:Prochlorperazine