chapter  16
Ventilatory control and breathlessness
ByPeter MA Calverley
Pages 21

The progress of ideas in respiratory physiology has often been accelerated by the need for practical solutions. Thus the clinical problems of gasmask design in the first world war led Haldane and coworkers to further study the stimulant effects of respiratory gases, whilst the hypoxia of high altitude experienced by second world war fighter pilots generated new research about the chemical regulation of human breathing. The subsequent rise in the incidence of and mortality from chronic obstructive pulmonary disease gave a new clinical dimension to these problems. The dangers of high concentrations of oxygen during acute exacerbations of COPD were soon recognized1 and led Campbell to apply new technologies to first identify the physiologic problem (hypercapnia), then hypothesize a mechanism for its production (reduced hypercapnic ventilatory drive) and finally suggest a practical solution (low-flow oxygen treatment by Venturi mask).2