The normal distribution of the hypoxic ventilatory response and methodological impacts: a meta‐analysis and computational investigation

作者：Britney Oeung, Kathy Pham, I. Mark Olfert, David J. De La Zerda, Eduardo Gaio, Frank L. Powell, Erica C. Heinrich · 发表于：The Journal of Physiology · 年份：2023 · DOI：10.1113/jp284767 · 被引用次数：26 · 研究领域：Neuroscience of respiration and sleep、High Altitude and Hypoxia、Heart Rate Variability and Autonomic Control

The hypoxic ventilatory response (HVR) is the increase in breathing in response to reduced arterial oxygen pressure. Over several decades, studies have revealed substantial population-level differences in the magnitude of the HVR as well as significant inter-individual variation. In particular, low HVRs occur frequently in Andean high-altitude native populations. However, our group conducted hundreds of HVR measures over several years and commonly observed low responses in sea-level populations as well. As a result, we aimed to determine the normal HVR distribution, whether low responses were common, and to what extent variation in study protocols influence these findings. We conducted a comprehensive search of the literature and examined the distributions of HVR values across 78 studies that utilized step-down/steady-state or progressive hypoxia methods in untreated, healthy human subjects. Several studies included multiple datasets across different populations or experimental conditions. In the final analysis, 72 datasets reported mean HVR values and 60 datasets provided raw HVR datasets. Of the 60 datasets reporting raw HVR values, 35 (58.3%) were at least moderately positively skewed (skew > 0.5), and 21 (35%) were significantly positively skewed (skew > 1), indicating that lower HVR values are common. The skewness of HVR distributions does not appear to be an artifact of methodology or the unit with which the HVR is reported. Further analysis demonstrated that the use of...