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J Physiol. 2005 December 15; 569(Pt 3): 975–987.
Published online 2005 October 13. doi: 10.1113/jphysiol.2005.089649.
PMCID: PMC1464268
Control of arterial PCO2 by somatic afferents in sheep
Philippe Haouzi and Bruno Chenuel
Laboratoire de Physiologie, E.A. 3450, Faculté de Médecine de Nancy, Université Henry Poincaré, France
Corresponding author P. Haouzi: Laboratoire de Physiologie, Faculté de Médecine de Nancy, Avenue de la Forêt de Haye, B.P. 184, 54505 Vandoeuvre-lès-Nancy Cedex, France. Email: p.haouzi/at/chu-nancy.fr
Received April 30, 2005; Accepted October 11, 2005.
Abstract
The ventilatory response (V˙E) to electrically induced rhythmic muscle contractions (ERCs) was studied in six urethane–chloralose-anaesthetized sheep, while arterial oxygen and carbon dioxide pressure (Pa,O2 and Pa,CO2) and perfusion pressure were maintained constant at the known chemoreception sites. With cephalic Pa,CO2 held constant, the response to inhaled CO2 was virtually abolished (0.03 ± 0.04 l min−1 Torr−1). During low-current ERC, which doubled the metabolic rate (V˙CO2 increased from 192 ± 23 to 317 ± 84 ml min−1, P < 0.01), V˙E followed the change in V˙CO2 closely (from 5.24 ± 1.81 to −9.27 ± 3.60 l min−1, P < 0.01) in the absence of any chemical error signal occurring at carotid and central chemoreceptor level (Δcephalic Pa,CO2=−0.75 ± 1 Torr). Systemic Pa,CO2 decreased by −2.47 ± 1.9 Torr (P < 0.01). Both heart rate and systemic blood pressure increased significantly by 18.6 ± 5.5 beats min−1 and 7.0 ± 9.3 mmHg, respectively. When the CO2 flow to the central circulation was reduced during ERC by blocking venous return (V˙CO2 decreased by 102 ± 45 l min−1, P < 0.01), ventilation was stimulated (from 11.99 ± 4.11 to 13.01 ± 4.63 l min−1, P < 0.05). The opposite effect was observed when the arterial supply was blocked. Finally, raising the CO2 content and flow in the systemic blood did not significantly stimulate ventilation provided that the peripheral and central chemoreceptors were unaware of the changes in blood CO2/H+ composition. Our results support the existence of a system capable of controlling blood Pa,CO2 homeostasis when the metabolism increases independently of peripheral and central respiratory chemoreceptors. Information from the skeletal muscles related to the local vascular response provides the central nervous system with a respiratory stimulus proportional to the rate at which gases are exchanged in the muscles, thereby coupling ventilation to the metabolic rate.
 
Since the very first experiments examining the ventilatory and gas exchange response to rhythmic muscle contractions induced by direct electrical stimulation of the hindlimb muscles of an anaesthetized animal (Morgan & Grodins, 1950), this approach has been used to clarify the mechanisms involved in blood gas homeostasis during dynamic exercise (Grodins & Morgan, 1950; Kao, 1963; Kao et al. 1963; Cross et al. 1982b; Jones et al. 1982; Huszczuk et al. 1986, 1993). Indeed, it has long been recognized that when moderate intensities of current are directly applied to the muscles, the ventilatory response to electrically induced rhythmic muscle contractions (ERCs) occurs only in the presence of the muscle contractions, and is independent of the electrical nature of the stimulation (Cross et al. 1982b). In addition, the ventilatory response to ERC is, as during a muscular exercise, proportional to the rise in pulmonary gas exchange rate (Morgan & Grodins, 1950; Cross et al. 1982b; Jones et al. 1982; Huszczuk et al. 1986), leading to an isocapnic response or to a very small decline in arterial carbon dioxide pressure (Pa,CO2).

Two distinct groups of mechanisms have been proposed to account for the ventilatory response (V˙E) to ERCs, and are therefore believed to be pertinent to the control of exercise hyperpnoea. The first group of mechanisms suggests that no specific exercise stimuli are required to explain the V˙EV˙CO2 coupling during ERC, but rather, that the V˙E response to ERC relies mainly on the chemical consequences of the contractions acting on the arterial chemoreceptors (Cross et al. 1982a). The rise in CO2 flow, encoded through the differential receptive properties of the carotid bodies, as suggested by the study of Yamamoto & Edwards (1960), was one of the prominent hypotheses in this group of proposed mechanisms (Phillipson et al. 1981; Cross et al. 1982a; Kumar et al. 1991). Such a system, optimized with information on the mechanical properties of the respiratory system, has even been suggested to account for the entire V˙E response, not only to ERC but also to a voluntary exercise (Poon, 1987) (the limits of this hypothesis are presented in the Discussion).

The second group of theories challenges the above mechanism, and was originally championed by Kao (Kao et al. 1963). It was proposed that non-chemoreceptor mechanisms, possibly related to the mechanical, metabolic or circulatory changes induced by the contractions (McCloskey & Mitchell, 1972), are essential to maintaining CO2/H+ homeostasis during ERC and therefore during exercise. The main argument formulated to support such a contention was that it is impossible to reproduce the characteristics of the V˙E response to ERC by changing the venous CO2 content. Indeed, according to much of the literature (Lewis, 1975; Greco et al. 1978; Ponte & Purves, 1978; Reischl et al. 1979; Fordyce & Grodins, 1980; Huszczuk et al. 1983; Shors et al. 1983; Bennett et al. 1984; Tallman et al. 1986), the V˙E response to venous CO2 loading appears to be hypercapnic and hypocapnic during CO2 unloading both at rest and during exercise. Secondly, many of these authors found that spinal cord section procedures or the destruction of the antero-lateral pathway resulted in a blunted V˙E response or the abolition of normal response to ERC, which was reduced to its chemical component (Grodins & Morgan, 1950; Kao, 1963; Cross et al. 1982b; Shors et al. 1983). The nature of the signal capable of accounting for a coupling between V˙E and factors proportional to the rate at which CO2 is ultimately produced and exchanged (Dejours, 1959; Whipp & Ward, 1991) remains unclear. More recent observations offer a means of reconciling the control of Pa,CO2 during ERC with a non-chemically mediated regulation of V˙E. The hypothesis is that the gas exchange rate in the muscles can be sensed during ERC, via a local (intramuscular) circulatory signal and could reflexly stimulate breathing through group III and IV muscle afferent fibres (Haouzi et al. 1999). In other words, it is proposed that the significant stimulus to breathe during physiological exercise and ERC may have its origin in the muscles with an afferent signal linked not only to the mechanical consequences of the contractions (Mense & Meyer, 1985; Pickar et al. 1994; Mense, 1996; Adreani et al. 1997) but also to the magnitude of the local vascular response (Huszczuk et al. 1993; Haouzi et al. 2004b), proportional to the metabolic load. Such a ventilatory regulatory system need not involve disturbance of Pa,CO2.

Using a model of functional isolation of the cephalic circulation in sheep (Haouzi et al. 2003), the present study addresses the following questions. (1) How is Pa,CO2 regulated during ERC when the chemical control of respiration is functional but unaware of the possible consequences of an increased metabolism? (2) Is the ventilation response to ERC comparable with the effects of increasing CO2 flow in the central circulation with no CO2/H+ changes in the cephalic circulation? (3) What are the effects of an acute change in the muscle circulation during ERC with a constant haemodynamic in the cephalic circulation?

Methods

Eight 2-year-old female sheep (45.9 ± 10.5 kg) were studied. All the experiments were performed in compliance with the recommendations of the Council of European Communities, and under licence from the Ministère Français de l'Agriculture et de la Pêche (registration number 54-42).

Anatomical basis of the isolated circulation
Details of the anatomical basis of the model and its validation have been described previously (Haouzi et al. 2003). Briefly, in sheep, the common carotid artery divides into an external carotid artery and an occipital artery (Baldwin & Bell 1963a, b). Each occipital artery joins the homolateral vertebral artery to constitute a well-developed occipito-vertebral anastomosis in the form of a loop. The vertebral arteries do not contribute to the formation of the basilar artery, and thus make no contribution to the blood supply to the circle of Willis or to the rete mirabile. The basilar artery can be regarded as a posterior branch of the circle of Willis where blood flows in a caudal direction. The blood from the vertebral arteries supplies only a small and variable portion of the dorsal medulla caudal to the obex by way of small and spare rami links to the terminal segment of the basilar trunk through the ventral spinal arteries (Baldwin & Bell, 1963a). When both carotid arteries are occluded in the sheep, the occipital arteries carry vertebral blood to the carotid system due to a reversal of flow supplying the entire brain and the cephalic structures (Waites, 1960). Conversely, we have shown that if a pressure gradient of 30 Torr is created between the carotid and the systemic systems, the direction of blood flow in the vertebral system is reversed (Fig. 1); the blood supplying the vertebral arteries comes entirely from the carotid system (Haouzi et al. 2003). The result of such a reversal of flow in the vertebral system is that the entire brainstem and even the cervical spinal cord are supplied by blood coming from the common carotid arteries. By maintaining a constant Pa,CO2 and Pa,O2 in the carotid circulation by means of a short extra-corporeal circuit placed on the common carotid arteries, it is possible to control the chemical composition of the blood and perfusion pressure at the arterial chemoreceptors (located at the origin of the occipital arteries) and at medullary level. We could confirm that with this model no blood could reach the peripheral and central chemoreceptors without passing through the carotid circuit (Haouzi et al. 2003). The new circulation can be regarded as being divided into two compartments (Fig. 1).
Figure 1Figure 1
Schematic representation of the circulation in the model
  • A cephalic compartment which is supplied by blood at any constant desired level of Pa,CO2, Pa,O2 and perfusion pressure. This compartment contains the carotid and the central chemoreceptors as well as the carotid baroreceptors.
  • A systemic compartment that is supplied by blood coming directly from the pulmonary veins mixed with a constant flow of blood coming through the occipital arteries back to the aorta.

The model used in the present study was modified from the original description as follows. Firstly, the level of Pa,O2 in the cephalic and systemic circulation was maintained at 150 Torr (instead of 400 Torr in the previous series of experiments). This was intended to prevent any stimulatory effect of hyperoxia in the central nervous system. Such an effect could have been responsible for a drift in V˙E during some of our previous tests. Second, a longer loop was used in the carotid circuit producing a delay of 20 s between the changes occurring in the systemic blood and at the site of re-injection in the carotid circuit. As a result, changes occurring in the composition of the systemic blood could be more accurately corrected in the blood supplying the cephalic circulation. Third, the vagus nerves were not cut.

Animal preparation
The sheep were pre-medicated with ketamine (15–20 mg kg−1, (i.m.)). Anaesthesia was induced by a loading dose of sodium thiopental (Nesdonal, 10–15 mg kg−1, (i.v.)), and subsequently maintained by a solution containing urethane and α-chloralose. Before performing the tracheostomy, 20 ml of a solution containing urethane (25%) and α-chloralose (5%) were injected. A second 20 ml injection of a solution containing urethane–α-chloralose (5%) was administered before the end of the surgery and then again 1 h later. The total doses of urethane and α-chloralose used were 150 and 70–80 mg kg−1 (i.v.), respectively. This anaesthetic protocol allowed us to maintain a stable level of ventilation for several hours without the periods of hypoventilation that typically occur when a single injection of urethane–chloralose is given. Spontaneous changes in breathing pattern, blood pressure and heart rate, and those induced by cutaneous stimulations were used to check the level of anaesthesia throughout the experiments.

The animals were tracheostomized and an inflatable-cuff tracheal cannula (Shilley no. 7, Mallinckrodt Medical, Irvine, CA, USA) was inserted through the tracheostomy. A catheter (Plastimed 3F, Plastimed, Saint-Len-La-Foret, France) was placed in one jugular vein for additional injection of anaesthetic agent.

After incision of the neck, the common carotid arteries were tied about 10–15 cm from the sinus region and incised on both sides of the ligature. Two large catheters (Bardic 18 Fr, Bard Cardiopulmonary Products Inc., Haverhill, MA, USA) were advanced rostrally and caudally into these incisions and tied to the carotid vessels. The cannulae were equipped with thin catheters that were introduced into each of the cephalic cannulae. After several pilot experiments, it was possible to select the length of the thin cephalic catheter according to the position of the cannulae to allow their tips to be close to the origin of the occipital and external carotid artery. A thin catheter was also introduced through one of the caudal cannulae and advanced into the abdominal aorta to measure systemic blood pressure.

The cephalic and caudal cannulae were connected through a double peristaltic rotor pump (Rhone-Poulenc 03, Hospal, Lyon, France). The flow delivered by the pump was determined by an electromagnetic flowmeter (Delaland Electronique, Courbevoie, France). The circuit consisted of a low-resistance hollow-fibre blood oxygenator (Terumo, Capiox SX 18, Terumo Cardiovascular Systems Corporation, USA). Blood temperature was maintained at 38.4°C by the gas exchanger and monitored (see below). The flow of O2 and CO2 into the inlet port of the gas compartment could be modified using a calibrated flowmeter.

To ensure permanent monitoring of the change in Pa,CO2 and Pa,O2 of the blood entering (‘systemic’ blood) and leaving (‘cephalic’ blood) the circuit, both these variables were measured continuously with a 3M CDI System 500 (Terumo, Cardiovascular Systems Corporation). This AC-powered microprocessor-based monitor, which is used during cardiopulmonary bypass in humans, allows a reliable estimate of blood PCO2, PO2, pH and temperature with a 20 s time-constant response (Mahutte et al. 1994; Southworth et al. 1998). Two disposable CDITH products, Tervhocardio-vascular system (CDI) shunt sensors made up of light-emitting diodes and fluorescent chemical microsensors were placed in a shunt bypass line, one in the circuit supplied with the systemic blood, the other downstream of the blood gas exchanger. Calibration was performed before each experiment using tonometer gases. The values obtained online by the CDI system were used to decide the time at which blood could be sampled and analysed (ABL 500 Radiometer, Copenhagen, The Netherlands), and to adjust the level of CO2 flow in the gas port during the transient phase when systemic Pa,CO2 changes. The relationship between the blood samples analysed with the ABL 500 and the data obtained from the 3M CDI System 500 is presented in Fig. 2.

Figure 2Figure 2
A, relationship between the Pa,CO2 values obtained from the 3M CDI System 500 (online Pa,CO2) and the Pa,CO2 values from arterial blood samples (Pa,CO2) (91 samples). B, frequency distribution of the difference between the online and direct (blood) measurements (more ...)

Measurements
The animals breathed through a two-way valve (Erich Jaeger, Geispolsheim, France) connected to the tracheostomy. A pneumotacograph (Prevent, Medical Graphics Inc., Saint Paul, Minnesota, USA), connected to a differential pressure transducer, was placed between the tracheal cannula and the valve to measure inspiratory and expiratory airflow. The pneumotachograph was calibrated using a 2 l syringe. Respiratory gases were sampled from the distal part of the tracheal cannula and the fractions of O2 and CO2 (FO2 and FCO2) were determined by zirconium and infrared fast responding analysers (Datex Analysers) Medical Graphics Inc., Saint Paul, Minnesota, USA). The expiratory flow and FCO2 signals were digitized at 100 Hz (modified Medical Graphics system). The flow signal was integrated for breath-by-breath calculation of tidal volume, minute ventilation (V˙E) in BTPS (body temperature, pressure saturated) conditions and V˙CO2 in STPD (standard temperature, pressure, dry) conditions. End-tidal CO2 pressure (PET,CO2) was determined for each breath.

The left and right carotid blood pressure and aortic blood pressure were continuously recorded (Statham pressure transducer, Gould Goddard, Oxnard, CA, USA). The fraction of CO2 delivered to the inlet port of the oxygenator and the pump flow rate signals were fed, along with the respiratory signals, to an analog-to-digital converter (Mac Laboratory System Adinstrument Ltd., Castle Hill, Australia) and displayed online on a monitor. The signals were digitized at 200 Hz. In addition, the data obtained from the CDI blood parameter monitoring system were fed to a microcomputer using a digital-to-analog converter.

Carotid PCO2 and PO2 (downstream of the gas exchanger) will be referred to as cPCO2 and cPO2, whereas systemic PCO2 and PO2 (upstream of the gas exchanger) will be referred to as sPCO2 and sPO2. Blood pressure from the raw data (MacLab, Maclaboratory System) was temporally aligned to the ventilatory data. The computed variables were stored on disk for further analysis.

Protocol and data analysis

CO2 inhalation The animals breathed a gas mixture containing oxygen to ensure that Pa,O2 was maintained at around 150 Torr. A control arterial blood sample was taken from the carotid and from the systemic circulation, the animal was then given CO2 to breathe for 5–6 min (mixture containing 7% CO2). Two types of tests were performed. In the first test, cPa,CO2 was maintained constant by adjusting the fraction of CO2 in the gas flowing in the extra-corporeal circuit. cPa,CO2 could be maintained constant even during the first minute of CO2 exposure by anticipating the change in cPa,CO2 (see Results). Online cPa,O2 was maintained at around 150 Torr. In the second type of test, cPa,CO2 was allowed to increase.

CO2 tests were performed prior to ERC and were repeated on three occasions during the experiments. The three tests were averaged for each animal.

ERC with the cephalic circulation isolated We modified our technique for contracting the hindlimb muscles (Haouzi et al. 1997) to be as close as possible to the approach used by Cross et al. (1982b) in anaesthetized dogs. The protocol of stimulation, the equipment and the electrodes were identical to those used for muscle training in patients with spinal cord lesion (Stimulator Parastep, Sigmedis Inc, Fairborn, OH, USA). The hindlimbs were shaved, and two pairs of large electrodes with conductive gel were placed on both thighs (Saint Cloud International Chantonnay, France). Muscle contractions were generated using a modulated stimulation frequency of 40 Hz, applied for 2 s every 4 s. Current intensity was set to between 10 and 15 mA with a rise and fall time of 0.5 s. Muscle contractions during this stimulation produced a rhythmic extension and adduction of the hindlimbs resembling dynamic exercise. The contractions were performed against a resistance consisting of rubber bands attached to the distal part of the limbs to double V˙E and metabolism, as previously reported (Haouzi et al. 1997). Contractions were performed with functional cephalic isolation for a period of 4–5 min. Each animal breathed either the mixture containing air and O2 or a mixture containing 7% CO2, which was administered 5 min prior to the onset of ERCs. The latter condition was intended, as at rest, to add an external source of CO2 flow to the central circulation, but through both an increase in CO2 content and flow (see Fig. 1 for additional explanations).

Vascular occlusions In three animals, a balloon-tipped catheter (Meditech, occlusion balloon catheter, 8F, Boston Scientific, Matick, MA, USA) was advanced into the inferior vena cava (IVC) via a saphenous vein and placed rostral to the iliac bifurcation. This balloon catheter allowed, on full inflation, the complete occlusion of the IVC (Haouzi et al. 1997). In two animals, a similar balloon was placed at abdominal aorta level.

The ventilatory responses to ERC obtained during the occlusion were not used to compute the response to ERC. Occlusions were performed for 45–60 s to avoid the confounding effects of ischaemic contractions on muscle afferent fibres (Kaufman et al. 1984; Mense & Meyer, 1985).

Killing procedure
At the end of the experiments, the extra-corporeal circulation was stopped during an injection of a 20 ml solution, containing high potassium and pentobarbitol concentrations, into the heart.

Statistical analysis
All data were averaged and expressed as mean ± standard deviation. A non-parametric test (Wilcoxon with paired series) was used to analyse firstly the effects of CO2 inhalation, i.e. control versus CO2 exposure on V˙E, cPa,CO2 and sPa,CO2; and secondly, the effects of ERC. The 45 s preceding CO2 inhalation or ERC were compared with the last 45 s of the tests. During occlusion, the 15 s preceding the period of occlusions were compared with the last 15 s of vascular occlusion.

Comparisons were made only on blood samples taken when online Pa,CO2 was stable. Statistical significance was based on P values less than 0.05.

Results

General comments
Data obtained from six of the eight experimental animals were analysed. In one sheep, the carotid canullae did not allow sufficient perfusion of the cephalic circulation, and in another a long period of periodic breathing made the measurement of steady responses problematic during the protocol. Throughout all the experiments, mean carotid pressure was maintained at 129.9 ± 25.8 mmHg and mean systemic arterial pressure was 65.7 ± 9.5 mmHg. This was achieved with pump flow rate of 1.08 ± 0.12 l min−1 (24 ± 5 ml min−1 kg−1). Cephalic Pa,O2 was maintained between 135 and 158 Torr in each animal (mean, 146.0 ± 6.5 Torr) while systemic Pa,O2 was 162.4 ± 40.7 Torr. A total of 34 ERC tests were analysed. Four animals performed two ERC tests in air and two tests with CO2. One of these four sheep underwent three ERC tests with venous occlusions. The remaining sheep had one ERC test in air and one test during CO2 inhalation, and each performed three tests with a venous occlusion and an arterial occlusion.

Effects of CO2 inhalation
The V˙E effects of CO2 inhalation were very similar to those described in our previous report (Haouzi et al. 2003). When Pa,CO2 was allowed to increase in the cephalic circulation from 44.9 ± 6.1 to 58.2 ± 8.4 Torr (Δ= 13.5 ± 3.6 Torr), V˙E increased by 8.9 ± 2.9 l min−1 (P < 0.01). The V˙E : Pa,CO2 ratio averaged 0.69 ± 0.25 l min−1 Torr−1 (14 ± 3 ml min−1 Torr−1 kg−1). When cPa,CO2 was maintained constant during CO2 inhalation (44.7 ± 6.3 Torr during air breathing versus 44.9 ± 6.1 Torr during CO2 breathing, Δ= 0.3 ± 1.5 Torr), sPa,CO2 increased from 40.7 ± 8.1 to 56.4 ± 7.1 Torr (Δ= 15.6 ± 3.7 Torr). An example is shown in Fig. 3. On average, the V˙E response was dramatically reduced although it was not null (6.72 ± 2.31 l min−1 during air breathing versus 7.04 ± 2.12 l min−1 during CO2 breathing). The difference was, however, not significant (P = 0.56). Ventilation followed the change (or the lack of change) in cPa,CO2 (Fig. 3). The V˙E : sPa,CO2 ratio was 0.03 ± 0.04 l min−1 Torr−1 (0.72 ± 0.80 ml min−1 Torr−1 kg−1). The V˙E response to an increase in sPa,CO2 was therefore depressed 20-fold.
Figure 3Figure 3
Example of the breath-by-breath ventilatory response to the inhalation of CO2 in one sheep when cephalicPa,CO2was maintained constant

Responses to ERC with isolation of the cephalic circulation

Air breathing Cephalic Pa,CO2 was 41.9 ± 2.1 Torr and sPa,CO2 was 43.1 ± 6.4 Torr before starting ERCs. In approximately half of the tests, we observed a transient irregular breathing pattern at the onset of ERC. This transient change in V˙E, which consisted of a moderate depression in breathing, disappeared within approximately 15 s, and was replaced by a progressive exponential-like increase in V˙E. Ventilation reached a steady state within 2 min (Figs 4 and 5). V˙CO2 increased from 192 ± 23 to 317 ± 84 ml min−1 at the end of the fourth minute (Δ= 125 ± 83 ml min−1, P < 0.01) and V˙E increased significantly from 5.24 ± 1.81 to 9.27 ± 3.6 l min−1 (Δ= 4.03 ± 2.9 l min−1, P < 0.01). The relationship between changes in V˙E and V˙CO2 is given in Fig. 6. Systemic Pa,CO2 decreased systematically by −2.47 ± 1.9 Torr (ΔsPa,CO2 ranged from −6.3 to −0.2 Torr, P < 0.01). No significant changes in Pa,CO2 occurred in the cephalic circulation (ΔcPa,CO2=−0.75 ± 1 Torr, n.s.).

Figure 4Figure 4
Example of the breath-by-breath ventilatory response to ERC in one sheep when cephalicPa,CO2was maintained constant
Figure 5Figure 5
Flow signal in one sheep during transition from rest to ERC
Figure 6Figure 6
ΔV˙E versus ΔV˙CO2 relationship for all the tests (•) when cPa,CO2was maintained constant

The circulatory response to hindlimb contractions consisted of a slight but significant rise in systemic mean arterial pressure (+7.0 ± 9.3 mmHg, P < 0.05), which typically occurred after an initial decrease in mean blood pressure. Heart rate increased significantly by 18.6 ± 5.5 beats min−1 (from 97.5 ± 14.6 to 116.1 ± 13.7 beats min−1, P < 0.01).

CO2 breathing An example of the response to ERC against a background of high systemic Pa,CO2 but unchanged cPa,CO2 is shown in Fig. 7. At rest, V˙E was 6.76 ± 2.21 ml min−1 during 7% CO2 breathing (versus 6.24 ± 2.52 l min−1 during air breathing), and sPa,CO2 rose from 37.6 ± 10.3 to 59.2 ± 4.6 Torr with no change in cPa,CO2 (44.1 ± 1.3 versus 43.1 ± 2.9 Torr). At the end of the ERC tests, V˙E reached the level of 11.4 ± 3.4 l min−1 versus 10.32 ± 3.85 l min−1 during air breathing (the difference was not significant). However, in contrast to ERC during air breathing, sPa,CO2 increased systematically by an average of 4.73 ± 1.38 Torr (from +1.9 to +6.1 Torr, P < 0.01). In other words, increasing the flow of CO2 to the arterial side during ERC produced a hypercapnic response when cPCO2 was maintained constant.

Figure 7Figure 7
Example of the breath-by-breath ventilatory response to ERC in one sheep when c Pa,CO2was maintained constant against a background of high sPa,CO2

Figure 8 summarizes, in one graph, the V˙E versus sPa,CO2 and cPaCO2 changes for all the above conditions.

Figure 8Figure 8
Mean (±s.d.) V˙E versus sPa,CO2and cPa,CO2relationships in all the animals during ERC and during CO2 breathing

Venous and arterial occlusions An example of consecutive occlusions is shown in Fig. 9 and average data are shown in Fig. 10. Occluding the inferior vena cava for 1 min during ERC provoked a dramatic reduction in sPa,CO2 that was difficult to anticipate and thus cephalic Pa,CO2 dropped by −4.3 ± 4 Torr (from −11 to −1 Torr, P < 0.01). V˙CO2 dropped by 102 ± 45 ml min−1 (P < 0.01). V˙E increased significantly from 11.99 ± 4.11 to 13.01 ± 4.63 l min−1 (P < 0.05) during the occlusion. Carotid pressure remained constant during the manoeuvre (+1.4 ± 3 Torr, 119.7 ± 27.3 versus 121.1 ± 25.3 mmHg). In other words, the increase in V˙E was not related to any change in carotid blood pressure and occurred despite a reduction in cPa,CO2. During aortic occlusion, V˙CO2 decreased by 59 ± 77 ml min−1 and V˙E dropped systematically from 13.92 ± 2.56 to 11.89 ± 2.69 l min−1 (P < 0.05) with a small reduction in cPa,CO2 (−1.5 ± 1.5 Torr). No change in carotid pressure was observed during the arterial occlusion (138.3 ± 27.9 versus 137.9 ± 29.4 mmHg).

Figure 9Figure 9
Example of the breath-by-breath ventilatory response to ERC with arterial occlusion (A) and obstruction of the vena cava (B)
Figure 10Figure 10
V˙E versus V˙CO2 relationship for all the tests during venous occlusion (left panel) and arterial occlusion (right panel) during ERC

Discussion

During ERC, when the peripheral and central respiratory chemosensitive areas were isolated from changes in CO2/H+ related to a rise in V˙CO2 (increases in either oscillations or mean value of Pa,CO2), we observed that ventilation increased in proportion to the rate of gas exchange, analogous to the closed-loop condition (Morgan & Grodins, 1950; Cross et al. 1982b; Huszczuk et al. 1983, 1986). A small decrease in ‘body’Pa,CO2 was observed. When the flow of CO2 into the systemic circulation via the pulmonary circulation was increased, at rest or during ERC, we found that there was no increase in respiratory drive to offset the subsequent rise in systemic Pa,CO2. It therefore appears that increasing CO2 flow to the central circulation, unrelated to a metabolic challenge, cannot trigger any stimulatory effects on V˙E provided that cephalic Pa,CO2 is not allowed to rise. Finally, the V˙E response was exaggerated when the venous return from the contracting muscles was blocked by venous occlusion, leading to a dramatic decrease in Pa,CO2 and systemic Pa,CO2. This effect was observed in the absence of arterial baroreceptor involvement. Opposite effects were observed during arterial occlusion, as already reported in dogs during ERC (Huszczuk et al. 1993).

Firstly, we shall briefly discuss the main characteristics of the model used and its chemosensitivity to CO2. The nature of the information that could control Pa,CO2 during contractions will then be examined and the possible implications for exercise hyperpnoea regulation discussed.

Isolation of the arterial supply to the carotid and central chemoreceptors in the sheep
Most of the characteristics of the model used in this study have already been discussed in detail (Haouzi et al. 2003). In the sheep and the goat, only a small but variable portion of the brainstem is normally supplied by blood coming from the vertebral vessels (Baldwin & Bell, 1963b). However, the need to control PCO2 or PO2 in the vertebral artery is crucial if a total functional isolation of all the possible medullary structures is to be obtained (Waites, 1960; Baldwin & Bell, 1963a). With the present preparation, any humoral factors in the systemic circulation will pass through the extra-corporeal circuit before reaching respiratory chemosensitive regions. This model allows us to maintain respiratory-related chemosensitive structures intact, and to maintain these structures at any desired level of Pa,CO2 or Pa,O2. The continuous exchange of gas between the blood and the gas exchanger effectively suppresses oscillations in blood gas composition normally related to the tidal nature of ventilation.

The V˙E response to an increase in cephalic Pa,CO2 was quite similar to values we published previously and to those available in the literature (Campbell & Vagedes, 1990). The CO2 sensitivity of the extra-cephalic compartment during CO2 inhalation decreases from 0.69 ± 0.25 l min−1 Torr−1 to almost zero (0.03 ± 0.04 l min−1 Torr−1) when Pa,CO2 changes were prevented in the carotid circulation. A residual increase in V˙E could still be observed in several tests, where Pa,CO2 increased in the body while cPa,CO2 was maintained constant. This effect was smaller than in our previous report (Haouzi et al. 2003). With the present circuit, we could prevent small rises in cephalic CO2 more effectively due to the longer delay imposed by the extra-corporeal circulation compared with the circuit used in the past. The lack of pronounced hyperoxia may have also prevented V˙E from drifting, making our measurements more reliable. We hypothesized that this remaining, albeit small, respiratory effect was related to some of the circulatory effects of the rise in systemic CO2 (see Haouzi et al. 2003, for discussion).

The animals were not vagotomized and, if anything, the V˙E effects of increasing body Pa,CO2 were smaller compared with those observed in our previous study with vagotomized animals. This confirms that the aortic chemoreceptors of sheep contribute little to breathing control. Finally, when PCO2 was increased in the airways the activity of the stretch receptors may have been depressed (Bartoli et al. 1974), an effect we would not have observed in our previous study. No changes in ventilation were observed that were indicative of a reduction in vagally mediated reflexes that mimic the effects of a vagotomy. This, however, may be due to the fact that the interaction of alveolar PCO2 with lung mechano-receptors operates mostly in the hypocapnic range.

Ventilatory effects of ERC with the cephalic circulation isolated
ERC has long been known to stimulate breathing in proportion to V˙CO2, and in a manner that mimics dynamic muscular exercise (Morgan & Grodins, 1950). Therefore, the ventilatory response to ERC in both humans and animals has been regarded as a situation that perfectly illustrates the terms of the debate on Pa,CO2 regulation during exercise: what are the mechanisms that allow alveolar ventilation to eliminate CO2 at the same rate as it is produced (V˙CO2), preventing Pa,CO2, and thus the H+ concentration, from rising in the arterial blood? The net result of such a regulation is that arterial Pa,CO2 is maintained constant (Grodins & Morgan, 1950; Huszczuk et al. 1986) or is decreased by a few torr (Cross et al. 1982b).

A low-intensity current was used to minimize the direct stimulation of afferent fibres and to prevent nociceptive stimuli (Cross et al. 1982b). The main limitation of this approach is that the metabolic rate, and thereby V˙E, can increase at best by a factor of two. We observed a small reduction in sPa,CO2 in this preparation. This suggests, as in the model of Bennett and Fordyce (1988), that the gain of specific exercise stimuli could be slightly higher than the total gain of the exercise hyperpnoea when all the control system mechanisms are allowed to operate. The apparent V˙EV˙CO2 coupling is still preserved and does not require the transduction of any CO2-related signal resulting from the rise in V˙CO2.

In the present preparation, since all the chemosensitive areas were kept intact but ‘unaware’ of any CO2- (and O2-) related changes occurring in the body, ventilatory control systems other than chemical increase V˙E in proportion to the metabolic rate during ERC. However, this conclusion does not agree with all the relevant literature. Indeed, as mentioned in the Introduction, there is a lack of agreement on the contribution of the respiratory chemoreceptors towards the V˙E response to ERC. This debate originates from an ongoing controversy.

The controversy pertains to the effects of spinal cord section on the V˙E response to ERC. Without reviewing all the elements of this debate, it is clear that the experimental evidence for spinal cord transmission of information during ERC appears to fall into conflicting categories ranging from a nearly complete absence of effect, to a reduction of the exercise hyperpnoea to its ‘chemical’ component (i.e. resulting from the chemical consequences of an elevated V˙CO2) (Grodins & Morgan, 1950; Kao, 1963; Cross et al. 1982b; Shors et al. 1983). The latter observation is to be expected if one accepts the proposition that denervation eliminates all neural information from the exercising limbs (transection of the spinal cord has been as high as T6). In such a situation, the animal should respond to electrical exercise in the same manner as the humoral dog in the cross-circulation experiments of Kao (1963), i.e. following the ventilatory response to hypercapnia.

Attempts to explain the first type of results, i.e. the persistence of an isocapnic hyperpnoea after denervation, have been numerous. The main problem is that a very similar relationship between V˙E and V˙CO2 is to be expected whether specific somatic information is operating or whether the responses are mediated exclusively through the chemical control of respiration (such as after spinal cord section). The direction of the deviation in Pa,CO2, small for moderate changes in V˙CO2, requires careful measurement of arterial blood gas and appropriate statistical analysis, as in the study by Cross et al. (1982b). Indeed, although these authors advocated the contribution of the chemical control of respiration during ERC, they found that the V˙E responses were always slightly hypocapnic (ΔPa,CO2=−2.1 Torr) when contraction-specific stimuli were allowed to operate, whereas Pa,CO2 increased (by +1.2 Torr) after hindlimb denervation. This difference in Pa,CO2 is precisely what would be expected if somatic information is regulating V˙E with the spinal cord intact. These deviations in Pa,CO2 have not always been studied and identified in every experiment dealing with spinal cord section, but were clearly acknowledged in early studies (Grodins & Morgan, 1950). Finally, it is intriguing that in some studies (Levine, 1979) that reported an ‘isocapnic’ increase in ventilation during ERC after spinal cord section, carotid body denervation did not affect the persisting V˙E response.

The transient reduction in breathing frequency that we observed in some tests at the onset of contractions (Fig. 5) has been found previously (Cross et al. 1982b). Although we did not examine the mechanisms of such an inhibitory effect, it is possible that a sudden muscle stimulation may have activated spinal reflexes which have been shown to inhibit breathing (Eldridge et al. 1981). This reflex may transiently override the stimulatory effect of the descending reticulo-spinal pathway at spinal motoneurone level (Eldridge et al. 1981).

Ventilatory response to CO2 flow unrelated to ERC
If the respiratory system was capable of sensing any change in CO2 flow in the central circulation, inhaling CO2 during ERC (which produced an increase in systemic blood CO2 flow unrelated to the muscle contractions) should have triggered a ventilatory response by itself. Indeed, in such a situation, systemic CaCO2 (and sPa,CO2) should increase in the extra-cephalic blood as a function of the rise in cardiac output in the absence of ventilatory response. We observed that in the absence of stimulation of the chemoreceptors by hypercapnia, the increase in CO2 flow unrelated to exercise-induced hyper-metabolism had no effect on ventilation and led to a rise in sPa,CO2 (see Figs 7 and 8). The present findings clearly demonstrate that any change in CO2 flow in the central circulation is incapable of providing a drive to breathe, and therefore an isocapnic (or hypocapnic) response in the absence of a chemical error signal. Thus, the proportional increase in V˙E and V˙CO2 during ERC must rely on different systems than those involved during CO2 inhalation (Lahiri & Forster 2003). This confirms a series of independent works showing that each time proper control measures were taken and changes in central blood flow or volume were prevented (see Greco et al. 1978, and Ponte & Purves, 1978, for discussion), venous CO2 loading and unloading trials at rest produced hypercapnic hyperpnoea and hypocapnic hypopnoea, respectively, whereas the ventilatory responses to venous CO2 unloading during exercise was hypocapnic (Lewis, 1975; Greco et al. 1978; Reischl et al. 1979; Fordyce & Grodins, 1980; Huszczuk et al. 1983; Shors et al. 1983; Bennett et al. 1984; Tallman et al. 1986).

The central nervous system therefore appears to be capable of encoding and using information related to factors proportional to V˙CO2 independently of the chemical component of this parameter.

Regulation of ventilation during ERC: effects of vascular occlusions
The idea that structures other than respiratory chemoreceptors have the capability of preventing a rise in Pa,CO2/[H+] during a metabolic challenge is not new. The search for a signal related to V˙CO2, independent of venous CO2 content, has led many physiologists to examine the idea that arterial CO2/H+ homeostasis relies on the adjustment of the respiratory control system to the change in blood flow (see Jones et al. 1982; Wasserman et al. 1986; Whipp & Ward, 1991, for discussion). The persistent and even larger increase in V˙E we found while the venous return was blocked shows that during ERC the rate of venous return (and thus V˙CO2) to the central circulation is not sensed, at least when the chemical control of breathing is not operating.

The effect of venous and arterial occlusions on the ventilatory response to ERC has already been reported during ERC in anaesthetized dogs (Huszczuk et al. 1993). Our results are consistent with these findings, since venous blockade stimulates breathing whereas ventilation is reduced during arterial occlusion. The present findings confirm that these effects do not rely on the arterial baroreflex.

Since a reduction in venous return to the central circulation is to be obtained during both the arterial and venous occlusions, why is the ventilatory response reduced during the arterial blockade and stimulated during the venous blockade? During the first minute of an arterial occlusion, the metabolic consequences of muscle ischaemia are minimized or absent (Kaufman et al. 1984; Mense, 1996), so the ventilatory response to contractions could only be affected by the putative consequences of the reduction in venous return, the reduction in peripheral vascular pressure and to a possible change in the magnitude of the contractions. Venous occlusion reduces venous return to the central circulation as well, but distends the venous ends of the muscle peripheral vascular bed. Therefore, in order to reconcile these two observations, it has been proposed (Huszczuk et al. 1993; Haouzi et al. 2004a) that a signal of circulatory nature originating in the peripheral vascular bed, rather than in the central circulation, could link the ventilatory response to the change in muscle circulation.

This speculation was supported by the observation that group III and IV afferent fibres take into account not only the level of muscle tension but also the level of the distension of the vascular structures in the muscle (Haouzi et al. 1999). The muscle post capillary bed appears to be an important site of mediation due to the large number of group IV endings located in the adventia of the muscular venular system.

The mechanical consequences of the contraction together with its local vascular response may well constitute the signal that is transduced, in the absence of local ischaemia, by the muscle afferents during ERC.

Implications for the control of breathing during exercise
The main question is whether this approach is relevant to our understanding of the control of V˙E during exercise. This question is as old as the use of ERC (Morgan & Grodins, 1950). The populations of endings recruited during ERC can be different (Adreani et al. 1997) and, as in any reduced preparation, the overall response when all structures can operate may not be predicted by our model. However, we believe that the present results emphasize the existence of a system capable of ‘controlling’Pa,CO2 without involvement of the chemical control of breathing. The V˙E–metabolism coupling can thus rely on a non-chemoreceptive control system of somatic origin, which may well be involved in day-to-day Pa,CO2 homeostasis as well as in pathological conditions. It should be stressed that the debate on the mechanisms of Pa,CO2 regulation during ERC is still of great importance; not only because it is one of the most controversial, and still unanswered, questions in respiratory physiology but also because our understanding of the mechanisms of V˙E control during exercise in many types of patients suffering from dyspnea on exertion would benefit from a better description of the structures involved in the V˙E–metabolism coupling.

Finally, the present results point towards a model of respiratory control that is different from that based solely on a peripheral neural drive to breathing during exercise, independent of the metabolic production. In such a model, any error signal resulting from a discrepancy between the ventilatory outcome of this neural drive and CO2 output would be controlled by chemoreflex feedback. Instead, it is proposed that information travelling through muscle afferent fibres, proportional to the vascular and thus the metabolic response, provides a neural link coupling V˙E to gas exchange in the working muscles. The degree of vasodilatation in the muscle could be used by the central nervous system as a marker of flow and thus of the circulatory component of the metabolism in the exercising tissues.

It is concluded that the arterial blood CO2/H+ composition during hyper-metabolism induced by rhythmic muscle contractions does not rely on the chemical regulation of breathing. Afferent fibres from the skeletal muscles appear to be capable of modulating their responses as a function of the degree of local vascular recruitment or vasodilatation. This system could provide the respiratory centres with an image of the metabolic rate changes in the tissues by sensing the extent of the vascular bed being perfused.

Acknowledgments

The authors are grateful to Bernard Chalon, Yvonne Bedez, Bernanrd Tousseul and Elizabeth Gerardt for their precious technical assistance. The study was supported by a grant from “Le Ministere de L'Enseignement et de la Recherche, EA3450” and from L'Univerisité H. Poincaré, Nancy, France.

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