| Physiological mechanisms of hyperventilation during human pregnancy. | |
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MedLine Citation:
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PMID: 18289946 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study examined the role of pregnancy-induced changes in wakefulness (or non-chemoreflex) and central chemoreflex drives to breathe, acid-base balance and female sex hormones in the hyperventilation of human pregnancy. Thirty-five healthy women were studied in the third trimester (TM(3); 36.3+/-1.0 weeks gestation; mean+/-S.D.) and again 20.2+/-7.8 weeks post-partum (PP). An iso-oxic hyperoxic rebreathing procedure was used to evaluate wakefulness and central chemoreflex drives to breathe. At rest, arterialized venous blood was obtained for the estimation of arterial PCO(2) (PaCO(2)) and [H(+)]. Blood for the determination of plasma strong ion difference ([SID]), albumin ([Alb]), as well as serum progesterone ([P(4)]) and 17beta-estradiol ([E(2)]) concentrations was also obtained at rest. Wakefulness and central chemoreflex drives to breathe, [P(4)] and [E(2)], ventilation and V CO(2) increased, whereas PaCO(2) and the central chemoreflex ventilatory recruitment threshold for PCO(2) (VRTCO(2)) decreased from PP to TM(3) (all p<0.01). The reductions in PaCO(2) were not related to the increases in [P(4)] and [E(2)]. The alkalinizing effects of reductions in PaCO(2) and [Alb] were partly offset by the acidifying effects of a reduced [SID], such that arterial [H(+)] was still reduced in TM(3) vs. PP (all p<0.001). A mathematical model of ventilatory control demonstrated that pregnancy-induced changes in wakefulness and central chemoreflex drives to breathe, acid-base balance, V CO(2) and cerebral blood flow account for the reductions in PaCO(2), [H(+)] and VRTCO(2). This is the first study to demonstrate that the hyperventilation and attendant hypocapnia/alkalosis of human pregnancy results from a complex interaction of pregnancy-induced changes in wakefulness and central chemoreflex drives to breathe, acid-base balance, metabolic rate and cerebral blood flow. |
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Authors:
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Dennis Jensen; James Duffin; Yuk-Miu Lam; Katherine A Webb; Jeremy A Simpson; Gregory A L Davies; Larry A Wolfe; Denis E O'Donnell |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-01-12 |
Journal Detail:
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Title: Respiratory physiology & neurobiology Volume: 161 ISSN: 1569-9048 ISO Abbreviation: Respir Physiol Neurobiol Publication Date: 2008 Mar |
Date Detail:
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Created Date: 2008-03-10 Completed Date: 2008-06-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101140022 Medline TA: Respir Physiol Neurobiol Country: Netherlands |
Other Details:
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Languages: eng Pagination: 76-86 Citation Subset: IM |
Affiliation:
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School of Kinesiology and Health Studies, Queen's University, Kingston, Ontorio, Canada K7L 3N6. Odj@queensu.ca |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acid-Base Equilibrium
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physiology* Adult Carbon Dioxide / blood, cerebrospinal fluid Estradiol / blood Female Humans Hydrogen-Ion Concentration Hyperventilation* Models, Theoretical Pregnancy / physiology* Progesterone / blood Pulmonary Ventilation / physiology* Serum Albumin Wakefulness |
| Chemical | |
Reg. No./Substance:
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0/Serum Albumin; 124-38-9/Carbon Dioxide; 50-28-2/Estradiol; 57-83-0/Progesterone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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