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What Is the Point of the Peak? Assessing Steady-State Respiratory Chemoreflex Drive in High Altitude Field Studies

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Arterial Chemoreceptors

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1071))

Abstract

Measurements of central and peripheral respiratory chemoreflexes are important in the context of high altitude as indices of ventilatory acclimatization. However, respiratory chemoreflex tests have many caveats in the field, including considerations of safety, portability and consistency. This overview will (a) outline commonly utilized tests of the hypoxic ventilatory response (HVR) in humans, (b) outline the caveats associated with a variety of peak response HVR tests in the laboratory and in high altitude fieldwork contexts, and (c) advance a novel index of steady-state chemoreflex drive (SS-CD) that addresses the many limitations of other chemoreflex tests. The SS-CD takes into account the contribution of central and peripheral respiratory chemoreceptors, and eliminates the need for complex equipment and transient respiratory gas perturbation tests. To quantify the SS-CD, steady-state measurements of the pressure of end-tidal (PET)CO2 (Torr) and peripheral oxygen saturation (SpO2; %) are used to quantify a stimulus index (SI; PETCO2/SpO2). The SS-CD is then calculated by indexing resting ventilation (L/min) against the SI. SS-CD data are subsequently reported from 13 participants during incremental ascent to high altitude (5160 m) in the Nepal Himalaya. The mean SS-CD magnitude increased approximately 96% over 10 days of incremental exposure to hypobaric hypoxia, suggesting that the SS-CD tracks ventilatory acclimatization. This novel SS-CD may have future utility in fieldwork studies assessing ventilatory acclimatization during incremental or prolonged stays at altitude, and may replace the use of complex and potentially confounded transient peak response tests of the HVR in humans.

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Acknowledgements

This work was supported in part by a Natural Sciences and Engineering Research Council of Canada Discovery grant (TAD) and an MRU sabbatical (TAD). We would like to acknowledge and thank ADInstruments for their support of this project. We are grateful to our research participants for their time and effort.

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Authors and Affiliations

  1. Department of Biology, Faculty of Science and Technology, Mount Royal University, Calgary, AB, Canada

    Christina D. Bruce, Gary Saran, Jamie R. Pfoh, Jack K. Leacy, Shaelynn M. Zouboules, Carli R. Mann, Joel D. B. Peltonen, Andrea M. Linares, Alexandra E. Chiew & Trevor A. Day

  2. Department of Physiology, University College Cork, Cork, Ireland

    Jack K. Leacy & Ken D. O’Halloran

  3. Kunde Hospital, Khunde, Solukhumbu, Nepal

    Mingma T. Sherpa

Authors
  1. Christina D. Bruce
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  2. Gary Saran
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  3. Jamie R. Pfoh
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  4. Jack K. Leacy
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  5. Shaelynn M. Zouboules
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  6. Carli R. Mann
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  7. Joel D. B. Peltonen
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  8. Andrea M. Linares
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  9. Alexandra E. Chiew
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  11. Mingma T. Sherpa
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  12. Trevor A. Day
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Corresponding author

Correspondence to Trevor A. Day .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA

    Estelle B. Gauda

  2. Faculty of Medical Sciences, Nova University of Lisbon Faculty of Medical Sciences, Lisbon, Portugal

    Maria Emilia Monteiro

  3. Department of Medicine, University of Chicago , Chicago, IL, USA

    Nanduri Prabhakar

  4. Department of Neuroscience, Cell Biology, Wright State University, Dayton, OH, USA

    Christopher Wyatt

  5. Cellular and Integrative Physiology, University of Nebraska, Omaha, NE, USA

    Harold D. Schultz

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Bruce, C.D. et al. (2018). What Is the Point of the Peak? Assessing Steady-State Respiratory Chemoreflex Drive in High Altitude Field Studies. In: Gauda, E., Monteiro, M., Prabhakar, N., Wyatt, C., Schultz, H. (eds) Arterial Chemoreceptors. Advances in Experimental Medicine and Biology, vol 1071. Springer, Cham. https://doi.org/10.1007/978-3-319-91137-3_2

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