Abstract
Respiratory control in chronic obstructive pulmonary disease was evaluated by studying the mechanics of respiration, the acid-base balance of arterial blood, and a carbon dioxide stimulation test. Of the various mechanical indices measured, the increase of inspiratory work per liter of ventilation was best related to the resting arterial carbon dioxide tension. This was thought to be the initiating factor for carbon dioxide retention in chronic obstructive pulmonary disease. The study of inspiratory work response to carbon dioxide inhalation revealed a shift of the curve to the right and a slight reduction of slope in patients with hyper-capnia. This was considered direct evidence of altered central responsiveness to carbon dioxide. The possible role of the change of bicarbonate concentration in plasma and cerebrospinal fluid on the change of central responsiveness to carbon dioxide in chronic obstructive pulmonary disease was discussed.

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