The effect of remifentanil on respiratory variability, evaluated with dynamic modeling

Mitsis, GD; Governo, RJM; Rogers, R; Pattinson, KTS

dc.contributor.author	Mitsis, GD	en
dc.contributor.author	Governo, RJM	en
dc.contributor.author	Rogers, R	en
dc.contributor.author	Pattinson, KTS	en
dc.date.accessioned	2014-03-01T01:32:08Z
dc.date.available	2014-03-01T01:32:08Z
dc.date.issued	2009	en
dc.identifier.issn	8750-7587	en
dc.identifier.uri	https://dspace.lib.ntua.gr/xmlui/handle/123456789/20047
dc.subject	Chemoreflex	en
dc.subject	Nonlinear models	en
dc.subject	Opioid	en
dc.subject	Ventilation	en
dc.subject	Volterra kernels	en
dc.subject.classification	Physiology	en
dc.subject.classification	Sport Sciences	en
dc.subject.other	remifentanil	en
dc.subject.other	carbon dioxide	en
dc.subject.other	narcotic analgesic agent	en
dc.subject.other	oxygen	en
dc.subject.other	piperidine derivative	en
dc.subject.other	adult	en
dc.subject.other	article	en
dc.subject.other	brain tissue	en
dc.subject.other	breathing mechanics	en
dc.subject.other	breathing pattern	en
dc.subject.other	breathing rate	en
dc.subject.other	dose response	en
dc.subject.other	drug brain level	en
dc.subject.other	drug effect	en
dc.subject.other	drug infusion	en
dc.subject.other	end tidal carbon dioxide tension	en
dc.subject.other	female	en
dc.subject.other	human	en
dc.subject.other	human experiment	en
dc.subject.other	low drug dose	en
dc.subject.other	lung model	en
dc.subject.other	male	en
dc.subject.other	nausea	en
dc.subject.other	normal human	en
dc.subject.other	priority journal	en
dc.subject.other	respiration control	en
dc.subject.other	respiratory tract parameters	en
dc.subject.other	steady state	en
dc.subject.other	tidal volume	en
dc.subject.other	algorithm	en
dc.subject.other	blood	en
dc.subject.other	heart rate	en
dc.subject.other	nonlinear system	en
dc.subject.other	physiology	en
dc.subject.other	reflex	en
dc.subject.other	statistical model	en
dc.subject.other	Adult	en
dc.subject.other	Algorithms	en
dc.subject.other	Analgesics, Opioid	en
dc.subject.other	Carbon Dioxide	en
dc.subject.other	Female	en
dc.subject.other	Heart Rate	en
dc.subject.other	Humans	en
dc.subject.other	Linear Models	en
dc.subject.other	Male	en
dc.subject.other	Models, Statistical	en
dc.subject.other	Nonlinear Dynamics	en
dc.subject.other	Oxygen	en
dc.subject.other	Piperidines	en
dc.subject.other	Reflex	en
dc.subject.other	Respiratory Mechanics	en
dc.subject.other	Young Adult	en
dc.title	The effect of remifentanil on respiratory variability, evaluated with dynamic modeling	en
heal.type	journalArticle	en
heal.identifier.primary	10.1152/japplphysiol.90769.2008	en
heal.identifier.secondary	http://dx.doi.org/10.1152/japplphysiol.90769.2008	en
heal.language	English	en
heal.publicationDate	2009	en
heal.abstract	Mitsis GD, Governo RJ, Rogers R, Pattinson KT. The effect of remifentanil on respiratory variability, evaluated with dynamic modeling. J Appl Physiol 106: 1038-1049, 2009. First published February 5, 2009; doi:10.1152/japplphysiol.90769.2008.-Opioid drugs disrupt signaling in the brain stem respiratory network affecting respiratory rhythm. We evaluated the influence of a steady-state infusion of a model opioid, remifentanil, on respiratory variability during spontaneous respiration in a group of 11 healthy human volunteers. We used dynamic linear and nonlinear models to examine the effects of remifentanil on both directions of the ventilatory loop, i.e., on the influence of natural variations in end-tidal carbon dioxide (PETCO2) on ventilatory variability, which was assessed by tidal volume (VT) and breath-to-breath ventilation (i.e., the ratio of tidal volume over total breath time VT/TTOT), and vice versa. Breath-by-breath recordings of expired CO2 and respiration were made during a target-controlled infusion of remifentanil for 15 min at estimated effect site (i.e., brain tissue) concentrations of 0, 0.7, 1.1, and 1.5 ng/ml, respectively. Remifentanil caused a profound increase in the duration of expiration. The obtained models revealed a decrease in the strength of the dynamic effect of PETCO2 variability on VT (the "controller" part of the ventilatory loop) and a more pronounced increase in the effect of VT variability on PETCO2 (the "plant" part of the loop). Nonlinear models explained these dynamic interrelationships better than linear models. Our approach allows detailed investigation of drug effects in the resting state at the systems level using noninvasive and minimally perturbing experimental protocols, which can closely represent real-life clinical situations.	en
heal.publisher	AMER PHYSIOLOGICAL SOC	en
heal.journalName	Journal of Applied Physiology	en
dc.identifier.doi	10.1152/japplphysiol.90769.2008	en
dc.identifier.isi	ISI:000264753000005	en
dc.identifier.volume	106	en
dc.identifier.issue	4	en
dc.identifier.spage	1038	en
dc.identifier.epage	1049	en