학술논문

Current definitions of the breathing cycle in alveolar breath-by-breath gas exchange analysis
Document Type
article
Source
AJP Regulatory Integrative and Comparative Physiology. 325(5)
Subject
Biological Sciences
Biomedical and Clinical Sciences
Health Sciences
Lung
Respiratory
Humans
Pulmonary Gas Exchange
Pulmonary Alveoli
Respiration
Breath Tests
Carbon Dioxide
Oxygen
cardiopulmonary exercise testing
gas exchange
gas exchange kinetics
lung gas stores
respiratory cycle
Medical and Health Sciences
Physiology
Biological sciences
Biomedical and clinical sciences
Health sciences
Language
Abstract
Identification of the breathing cycle forms the basis of any breath-by-breath gas exchange analysis. Classically, the breathing cycle is defined as the time interval between the beginning of two consecutive inspiration phases. Based on this definition, several research groups have developed algorithms designed to estimate the volume and rate of gas transferred across the alveolar membrane ("alveolar gas exchange"); however, most algorithms require measurement of lung volume at the beginning of the ith breath (VLi-1; i.e., the end-expiratory lung volume of the preceding ith breath). The main limitation of these algorithms is that direct measurement of VLi-1 is challenging and often unavailable. Two solutions avoid the requirement to measure VLi-1 by redefining the breathing cycle. One method defines the breathing cycle as the time between two equal fractional concentrations of lung expired oxygen (Fo2) (or carbon dioxide; Fco2), typically in the alveolar phase, whereas the other uses the time between equal values of the Fo2/Fn2 (or Fco2/Fn2) ratios [i.e., the ratio of fractional concentrations of lung expired O2 (or CO2) and nitrogen (N2)]. Thus, these methods identify the breathing cycle by analyzing the gas fraction traces rather than the gas flow signal. In this review, we define the traditional approach and two alternative definitions of the human breathing cycle and present the rationale for redefining this term. We also explore the strengths and limitations of the available approaches and provide implications for future studies.