Inert gas wash-out from tissue: model analysis

An overview of the phylogeny of cardiorespiratory control in vertebrates with some reflections on the 'Polyvagal Theory'

Mammals show clear changes in heart rate linked to lung ventilation, characterized as respiratory sinus arrhythmia (RSA). These changes are controlled in part by variations in the level of inhibitory control exerted on the heart by the parasympathetic arm of the autonomic nervous system (PNS). This originates from preganglionic neurons in the nucleus ambiguous that supply phasic, respiration-related activity to the cardiac branch of the vagus nerve, via myelinated, efferent fibres with rapid conduction velocities. An elaboration of these central mechanisms, under the control of a 'vagal system' has been endowed by psychologists with multiple functions concerned with 'social engagement' in mammals and, in particular, humans. Long-term study of cardiorespiratory interactions (CRI) in other major groups of vertebrates has established that they all show both tonic and phasic control of heart rate, imposed by the PNS. This derives centrally from neurones located in variously distributed nuclei, supplying the heart via fast-conducting, myelinated, efferent fibres. Water-breathing vertebrates, which include fishes and larval amphibians, typically show direct, 1:1 CRI between heart beats and gill ventilation, controlled from the dorsal vagal motor nucleus. In air-breathing, ectothermic vertebrates, including reptiles, amphibians and lungfish, CRI mirroring RSA have been shown to improve oxygen uptake during phasic ventilation by changes in perfusion of their respiratory organs, due to shunting of blood over across their undivided hearts. This system may constitute the evolutionary basis of that generating RSA in mammals, which now lacks a major physiological role in respiratory gas exchange, due to their completely divided systemic and pulmonary circulations.

Evolutionary trends in airway CO2/H+ chemoreception

In many species of air-breathing vertebrates CO2-sensitive airway receptors play an important role in ventilatory control. In ectotherms, olfactory receptors often inhibit breathing and prolong breath holding when environmental CO2 levels are high. CO2/H+ sensitive pulmonary receptors (intra pulmonary chemoreceptors (IPC) and pulmonary stretch receptors (PSR)) regulate breathing patterns in all vertebrates in a manner that reduces dead space ventilation and enhances the efficiency of CO2 excretion under conditions of environmental hypercarbia, and/or reduces CO2 loss from hyperventilation. The greater CO2 sensitivity of IPC may allow them to also serve as a venous CO2 receptor (at least transiently when levels of metabolically produced CO2 begin to rise), prevent alkalosis during hyperpnea/polypnea, and may have contributed to the evolution of the extremely thin air/blood barrier and increased diffusion capacity associated with the rigid avian lung. The presence of all three receptor groups with different degrees of CO2 sensitivity in most reptiles, however, gives rise to what appear to be anomalous responses to environmental CO2.

The physiological kinetics of nitrogen and the prevention of decompression sickness

Decompression sickness (DCS) is a potentially crippling disease caused by intracorporeal bubble formation during or after decompression from a compressed gas underwater dive. Bubbles most commonly evolve from dissolved inert gas accumulated during the exposure to increased ambient pressure. Most diving is performed breathing air, and the inert gas of interest is nitrogen. Divers use algorithms based on nitrogen kinetic models to plan the duration and degree of exposure to increased ambient pressure and to control their ascent rate. However, even correct execution of dives planned using such algorithms often results in bubble formation and may result in DCS. This reflects the importance of idiosyncratic host factors that are difficult to model, and deficiencies in current nitrogen kinetic models. Models describing the exchange of nitrogen between tissues and blood may be based on distributed capillary units or lumped compartments, either of which may be perfusion- or diffusion-limited. However, such simplistic models are usually poor predictors of experimental nitrogen kinetics at the organ or tissue level, probably because they fail to account for factors such as heterogeneity in both tissue composition and blood perfusion and non-capillary exchange mechanisms. The modelling of safe decompression procedures is further complicated by incomplete understanding of the processes that determine bubble formation. Moreover, any formation of bubbles during decompression alters subsequent nitrogen kinetics. Although these factors mandate complex resolutions to account for the interaction between dissolved nitrogen kinetics and bubble formation and growth, most decompression schedules are based on relatively simple perfusion-limited lumped compartment models of blood: tissue nitrogen exchange. Not surprisingly, all models inevitably require empirical adjustment based on outcomes in the field. Improvements in the predictive power of decompression calculations are being achieved using probabilistic bubble models, but divers will always be subject to the possibility of developing DCS despite adherence to prescribed limits.

Elimination kinetics of acetylene and Freon 22 in resting and active lungless salamanders

To quantify diffusion limitation in cutaneous gas exchange, the elimination of two inert gases of different diffusivity, Freon 22 (CHC1F2) and acetylene (C2H2), was measured simultaneously in exclusively skin-breathing lungless salamanders, Desmognathus quadramaculatus. In resting salamanders, elimination of both gases could be described as the sum of three exponential terms. For both the medium and the slow exponential component, the ratio of the respective rate constants (k) for acetylene and Freon averaged 1.77. This value is between the values expected for perfusion limitation (1.00) and diffusion limitation (1.94), indicating combined diffusion and perfusion limitation. In salamanders stimulated to run on a treadmill, the elimination rates and the rate constants increased more for Freon than for acetylene. During spontaneous activity, the increase in elimination of Freon was larger than that of acetylene. These findings suggest an increase in the diffusing capacity of the skin during exercise. Thus the diffusing capacity of salamander skin for gases appears to be variable and to be adjusted to meet the increased O2 requirement during exercise.

Role of diffusion shunt in transfer of inert gases and O2 in muscle

Diffusion shunt is diffusive gas exchange between arterial and venous vessels. Evidence for diffusion shunt had been obtained in washout studies in the gastrocnemius muscle of the dog. According to models, diffusion shunt is expected to be enhanced at low blood flow, and for gases of high diffusivity. Shunting of O2 should be reduced in comparison to inert gases because of chemical binding in blood.