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(Chest. 2000;117:205-225.)
© 2000 American College of Chest Physicians

The Control of Breathing in Clinical Practice*

Brendan Caruana-Montaldo, MD; Kevin Gleeson, MD and Clifford W. Zwillich, MD, FCCP

* From the Pulmonary, Allergy, and Critical Care Section (Dr. Gleeson), The Penn State Geisinger Health System, Hershey, PA; St. Vincent’s Hospital (Dr. Caruana-Montaldo), St. Verona, Malta; and the Denver VA Medical Center (Dr. Zwillich), Denver, CO.

Correspondence to: Kevin Gleeson, MD, Pulmonary, Allergy, and Critical Care Section, The Penn State Geisinger Health System, 500 University Dr, Hershey, PA 17036

The control of breathing results from a complex interaction involving the respiratory centers, which feed signals to a central control mechanism that, in turn, provides output to the effector muscles. In this review, we describe the individual elements of this system, and what is known about their function in man. We outline clinically relevant aspects of the integration of human ventilatory control system, and describe altered function in response to special circumstances, disorders, and medications. We emphasize the clinical relevance of this topic by employing case presentations of active patients from our practice.

Key Words: carotid body • chemoreceptors • control of ventilation • pulmonary receptors




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