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Semin Respir Crit Care Med 2023; 44(05): 627-649
DOI: 10.1055/s-0043-1770342
Review Article

Control of Breathing

Jerome A. Dempsey
1   John Rankin Laboratory of Pulmonary Medicine, Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin
,
Joseph F. Welch
2   School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
› Author Affiliations Funding Grant support for this study was provided by NHLBI.
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Abstract

Substantial advances have been made recently into the discovery of fundamental mechanisms underlying the neural control of breathing and even some inroads into translating these findings to treating breathing disorders. Here, we review several of these advances, starting with an appreciation of the importance of V̇A:V̇CO2:PaCO2 relationships, then summarizing our current understanding of the mechanisms and neural pathways for central rhythm generation, chemoreception, exercise hyperpnea, plasticity, and sleep-state effects on ventilatory control. We apply these fundamental principles to consider the pathophysiology of ventilatory control attending hypersensitized chemoreception in select cardiorespiratory diseases, the pathogenesis of sleep-disordered breathing, and the exertional hyperventilation and dyspnea associated with aging and chronic diseases. These examples underscore the critical importance that many ventilatory control issues play in disease pathogenesis, diagnosis, and treatment.

Keywords

chemoreception - exercise hyperpnea - plasticity - sleep-disordered breathing - respiratory rhythm generation - exertional dyspnea - COPD - CHF - aging


Publication History

Article published online:
11 July 2023

© 2023. Thieme. All rights reserved.

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