Effect of voluntary respiratory efforts on breath-holding time

IntroductionNear the end of a maximal voluntary breath-hold, re-inhalation of the expired gas allows an additional period of breath-holding, indicating that the breaking point does not depend solely on chemical drive. We hypothesized that afferents from respiratory muscle and/or chest wall are significant in breath-holding.MethodsNineteen normal adults breathed room air through a mouthpiece connected to a pneumotachograph and were instructed to breath-hold with and without voluntary regular respiratory efforts against an occluded airway.ResultsFifty one trials with and 53 without respiratory efforts were analyzed. The mean number of efforts per minute was 19 ± 2.3 and the mean lowest airway pressure (Paw) −16.6 ± 5.4 cmH2O. Breath-holding time (BHT) did not differ without (33.0 ± 18.2 s) and with (29.3 ± 12.3 s) efforts. In five patients arterial blood gasses were measured before and at the end of breath-holding and they did not differ between trials without and with efforts, indicating similar chemical drive. Our results suggest that afferents from respiratory muscle and/or chest wall are not the major determinants of BHT.