Clinical investigation of abnormalities of ventilatory regulation

The clinical assessment of disorders of ventilatory regulation is based on an understanding of the physiology of the control of ventilation in man. Apart from clinical examination and standard pulmonary function tests, recent research studies have provided newer tests that can be applied in clinical practice. These consist mainly of studies of the patient at rest, relating arterial blood gas values to minute ventilation and minute ventilation to mouth occlusion pressure. In selected cases, further insight can be gained by the measurement of ventilation and mouth occlusion pressure during progressive hypercapnia or hypoxia. In rare instances, electromyographic studies of the diaphragm and exercise studies may provide additional clinical information. The rational application of these tests to the assessment of ventilatory disorders provides a clearer understanding of the site and type of abnormality and can provide a better guide to therapy.