PT  - JOURNAL ARTICLE
AU  - S Launois
AU  - T Similowski
AU  - B Fleury
AU  - M Aubier
AU  - D Murciano
AU  - B Housset
AU  - R Pariente
AU  - JP Derenne
TI  - The transition between apnoea and spontaneous ventilation in patients with coma due to voluntary intoxication with barbiturates and carbamates
AID  - 10.1183/09031936.93.03050573
DP  - 1990 May 01
TA  - European Respiratory Journal
PG  - 573--578
VI  - 3
IP  - 5
4099  - http://erj.ersjournals.com/content/3/5/573.short
4100  - http://erj.ersjournals.com/content/3/5/573.full
SO  - Eur Respir J1990 May 01; 3
AB  - We have investigated the transition from apnoea to spontaneous breathing in five comatose patients self intoxicated with barbiturates and carbamates. All patients were apnoeic on admission, and were studied throughout the course of recovery. The transition between the first respiratory movements and a stable and nearly normal ventilation (stable respiratory activity) ranged from 15 to 105 min, a very short time compared to the duration of the apnoeic state that lasted 6 to 72 h from admission. Minute ventilation and occlusion pressure during the first respiratory movements were 6.3 +/- 2.7 l.min-1 and 1.35 +/- 0.45 kPa, respectively. These values increased by roughly 50 and 100% by the time stable respiratory activity was achieved. The increase in minute ventilation was entirely due to an increased inspiratory flow, in relation to a proportionate increase in occlusion pressure, and without significant changes in the respiratory times or in the effective elastance. We conclude that the transition between apnoea and stable respiratory activity is characterized by its rapidity, by the fact that respiratory times are fixed throughout the recovery process, and by the fact that effective elastance is high.