The Regulation Of Respiration During Sleep And Anesthesia

During the 1976 Fall Meeting of the American Physiological Society Dr. Lahiri and I learned that no plans were being formu lated for holding a symposium on Respiratory Control during the 1977 International Congress. Not to hold such a symposium, we felt, would be the loss of a unique opportunity for us "regula tionists" to exchange ideas viva voce with our international colleagues. It would also break a tradition most recently enjoyed at Srinagar, India in 1974 and at Warsaw, Poland in 1971. After a time-consuming false start we had the good fortune to get advice from Dr. Pierre Dejours to make our plans known to Dr. Henry Gautier. This we did. There resulted an excellent three days of discussion and hospitality at the Faculte de Medecine Saint-Antoine in Paris immediately preceding the International Congress. The aim of the co-chairmen was to gather an international mixture of both the younger and more senior experts to discuss, argue, and maybe even agree on a point or two arising from their current investigations. We wanted to feature, however, recent research trying to determine the influence of sleep and anesthesia on the regulation of respiration. That the sessions were lively and presumably profitable was never more in evidence than when on the second day at 6:15 p.m. after fully nine hours of discussion, argumentation, and some agreement I counted 78 participants still participating.

Contrary to the popular belief, "Le sommeil n'est plus milieu s(lr" (J. Cocteau, cf. Cl. Gaultier, Pathologie respiratoire du sommeil, La Presse Medicale, 16, 561-563, 1987), and anesthesia is even less safe. Sudden Infant Death Syndrome, Obstructive Sleep Apnea, Ondine's Curse and various respiratory complications of general anesthesia are not so rare; as a matter of fact they happen much too frequently. The idea of organizing another symposium dealing with breathing in sleep and anesthesia has been discussed almost immediately after we said "good bye" to the Organizers of the excellent Paris meeting "The Regulation of Respiration during Sleep and Anesthesia" (R.S. Fitzgerald, H. Gautier, S. Lahiri eds., Advances in Experimental Medicine and Biology, vol. 99, Plenum, New York 1978). Taking into account the impressive amount of data that have emerged during the last few years, we have decided that we shall meet and discuss them; we hoped also that the publication of the scientific material might be useful for everybody interested in the physiology and pathophysiology of breathing, anesthesia and sleep. So we met in Warsaw under the auspices of the European Society for Clinical Respiratory Physiology and the Polish Academy of Sciences, we discussed vividly many fascinating papers presented by our Colleagues from Europe and America and Plenum Press has published the proceedings. I hope that the final result will satisfy the reader.

Presents a modern vision of anaesthesia, integrating technology and knowledge, to change how anaesthesia is taught and practised.

Physiology in Sleep provides the physiological definition of sleep and presents the philosophical approach to sleep that departs from pharmacological and neurophysiological theories of sleep. This book discusses the effects of sleep on cardiovascular and respiratory function, cerebral metabolism and blood flow, as well as temperature regulation. Comprised of eight chapters, this text starts with an overview of the cardiovascular changes that occur during sleep and its direct relevance to human physiology and disease. This book then explores the variety of sleep stages, characteristics, and possible functions. Other chapters consider the evidence of nychtohemeral rhythmicity in man’s hormones that subserve growth, maturation, nurture, reproduction, mineral metabolism, energy regulation, adaptation, and survival. This book further discusses the gastric, esophageal, and intestinal functioning during sleep. The final chapter explores the sleep apnea syndromes and some examples of the sudden infant death syndrome. This book is intended for readers seeking a detailed account of physiology in sleep.

Experimentalists tend to revel in the complexity and multidimensionality of biological processes. Modelers, on the other hand, generally look towards parsimony as a guiding prin ciple in their approach to understanding physiological systems. It is therefore not surprising that a substantial degree of miscommunication and misunderstanding still exists between the two groups of truth-seekers. However, there have been numerous instances in physiology where the marriage of mathematical modeling and experimentation has led to powerful in sights into the mechanisms being studied. Respiratory control represents one area in which this kind of cross-pollination has proven particularly fruitful. While earlier modeling ef forts were directed primarily at the chemical control of ventilation, more recent studies have extended the scope of modeling to include the neural and mechanical aspects pertinent to respiratory control. As well, there has been a greater awareness of the need to incorpo rate interactions with other organ systems. Nevertheless, it is necessary from time to time to remind experimentalists of the existence of modelers, and vice versa. The 4th Annual Biomedical Simulations Resource (BMSR) Short Course was held in Marina Del Rey on May 21-22,1989, to acquaint respiratory physiologists and clinical researchers with state-of-the art methodologies in mathematical modeling, experiment design and data analysis, as well as to provide an opportunity for experimentalists to challenge modelers with their more recent findings.

This volume contains the papers presented at the symposion on Central Neurone Environment and the Control Systems of Breathing and Circulation held at Bochum, October 5-7,1981 in honour of Prof. Dr. Dr. h.c. Hans H. Loeschcke, who retired in March 1981. His discovery of ventral medullary substrates forming an essential drive for the ventilatory as well as for circulatory control systems, and the elaboration of this concept during the last 25 years have profoundly influenced the concepts in this field. In an age of proceeding specializa tion on partial mechanisms, his approach has always emphasized the integrative aspects of the control systems, especially the role of the respiratory control system for the ionic homeostasis of the brain and the close interrelation between neuronal respiratory and cardiovascular control. This general intention implies the combination of physico chemical and neurophysiological approaches as well as the study of peripheral function of respiration and circulation, topics which are usually handled separately according to the different methods.