Gaseous signaling molecules are gaseous molecules that are either synthesised internally (endogenously) in the organism, tissue or cell or are received by the organism, tissue or cell from outside (say, from the atmosphere or hydrosphere, as in the case of oxygen) and that are used to transmit chemical signals which induce certain physiological or biochemical changes in the organism, tissue or cell. The term is applied to, for example, oxygen, carbon dioxide, sulfur dioxide, nitrous oxide, hydrogen cyanide, ammonia, methane, hydrogen, ethylene, etc. Wikipedia accessed January 24 2022
“Changes and anomalies in respiratory rate are not simply associated with respiratory conditions—they are a good indicator that a patient is struggling to maintain homeostatic control (the body’s internal environment). Respiratory rate is an early, extremely good indicator of physiological conditions such as hypoxia (low levels of oxygen in the cells), hypercapnia (high levels of carbon dioxide in the bloodstream), metabolic and respiratory acidosis”. April 2019 British Journal of Nursing Vol. 28, No. 8 [Clinical] The importance of respiratory rate monitoring Sandy Rolfe
Since the brain monitors and regulates respiratory rate [and the skeletal respiratory muscles] involuntarily and [maybe voluntarily-in that it may feel good] in response to endogenous levels of carbon dioxide [which is continually produced by cell metabolism], Paula and I would like to emphasize the importance of the partial pressure of endogenous carbon dioxide in driving biological processes in the blood, tissues and cells of the body and central nervous system, [skeletal motor changes implicate the spinal cord and its nerves as well as the brain]. * “The spinal cord is a long bundle of nerves and cells that extends from the lower portion of the brain to the lower back. It carries signals between the brain and the rest of the body”. A guide to the spinal cord: Anatomy and injuries https://www.medicalnewstoday.com/articles/326984
And since respiratory rate is regulated according to carbon dioxide levels in the body, I would think that monitoring baseline respiratory rates at rest and understanding individual differences responding to endogenous and exogenous CO2 would be important, especially if baseline respiratory rates were found to be below 8 breaths per minute or higher than 25 breaths per minute at baseline.
Testing responses of respiratory rates to carbon dioxide challenges during upper respiratory obstructions [a cold] or exercise would seem useful in finding out if feedback mechanisms to deal with fluctuations [intermittent or chronic] are normal or impaired. Such monitoring would have been important in a case such as Paula’s , especially when she suffered an chronic attack of fear, cognitive impairment, personal memory loss and difficulty speaking and communicating which can be an attack of hypercapnia encephalopathy.
It bears repeating that…… “Changes and anomalies in respiratory rate are not simply associated with respiratory conditions—they are a good indicator that a patient is struggling to maintain homeostatic control (the body’s internal environment). Respiratory rate is an early, extremely good indicator of physiological conditions such as hypoxia (low levels of oxygen in the cells), hypercapnia (high levels of carbon dioxide in the bloodstream), metabolic and respiratory acidosis”. April 2019 British Journal of NursingVol. 28, No. 8 Clinical The importance of respiratory rate monitoring Sandy Rolfe
Early physiologists [Haldane, Severinghaus, etc..] noted that the respiratory rates of normal healthy adults were very wide; from as low as 3 breaths per minute to as high as 28 breaths per minute at baseline during rest. This makes it seem like counting the respiratory rate is a waste of time since normal values are so variable but while it may be less important in health, it may be extremely useful in diagnosing possible homeostatic problems. In illness, especially in states involving cognitive impairment and memory loss and motor changes, Paula and think that counting the respiratory rate and if abnormal, tidal volume and minute ventilation is important. It is also non invasive and easy to do. Any doctor or nurse can arrange to have this done.
It is very likely that Paula’s depressed respiratory rate is just good enough to maintain normal minute ventilation under normal circumstances but is not adequate during the increased metabolism of physical illness, during period of developmental hormonal change and/or during exposure to high levels of indoor and/outdoor combustion gases and particulates while trying to maintain normal locomotor activity AND straight posture AND normal feeding, digestion and urinating/defecating, since all of these functions require use of the skeletal muscles and of energy reserves. All of these functions [standing or sitting up straight, feeding, digestion, urination, defecating, etc…were inhibited, along with respiratory rate, during Paula’s attack of depressive insanity.
When healthy, Paula has normal blood pressure, heart function and heart rate and body temperature and normal bodily functions described above. When mentally confused and distressed and silent, Paula’s vital signs, in addition to her abnormal breathing rate, suddenly become abnormal. Her blood pressure become abnormal [too high] , her heart function become abnormal [palpitations, possible arrhythmia’s, fast heart rate] and her body temperature becomes lower than normal. [perhaps partially due to motor inactivity and because of vasoconstriction in the extremities] .
Paula most likely had depressed rates of breathing due to damage suffered at birth, probably from * being born not breathing when she got stuck in the crooked birth canal of her Mother who’s lower body had been deformed by Rickets during infancy [most likely due to poverty and lack of sunlight in crowded poorly kept urban surroundings] and from * unintended effects of swallowing meconium, and unintended effects of being suctioned [meconium], resuscitated and transfused….all resulting in a hugely successful outcome, despite everything. Paula was born in Paris France and it was the custom then to swaddle the newborn and have them sleep on their back: If Paula was at risk of SIDS [sudden infant death syndrome] due to her birth issues, the risks were lowered by having her sleep on her back, which today is recommenced as a way to avoid SIDS in susceptible infants.
So luck was with Paula when she was born and her life and her quality of life were courageously saved by the supportive medical techniques of the day in 1955 Paris France.
No one knew Paula’s birth and paediatric medical history when she became sick with a bipolar depressive attack around menopausal hormonal changes.
It is possible that Paula’s respiratory rate and peripheral motor ventilatory system were affected way back then and that neither she or anyone else were aware of this. Although first year medical books teach the importance of counting the respiratory rate, blood pressure, heart rate and body temperature at baseline at rest in health and to look for changes during illness, this is not routinely done or taken very seriously. This is why respiratory rate is the most neglected vital sign even though it can suggest issues with the lungs or the skeletal motor system and homeostasis and the complex relationships between them , under the careful watch of the nervous system.
Carbon dioxide is no longer considered simply a “waste gas”. It is considered a gaseous singling molecule, continuously produced by the cells. In order to retain the most effective dose in the body, the excess must be exhaled. Exhaling requires an intact ventilatory system and intact lungs; it is a whole body teamwork process requiring complex orchestration.
Carbon dioxide (CO2) is a fundamental physiological gas known to profoundly influence the behaviour and health of millions of species within the plant and animal kingdoms in particular. A recent Royal Society meeting on the topic of ‘Carbon dioxide detection in biological systems’ was extremely revealing in terms of the multitude of roles that different levels of CO2 play in influencing plants and animals alike. While outstanding research has been performed by leading researchers in the area of plant biology, neuronal sensing, cell signalling, gas transport, inflammation, lung function and clinical medicine, there is still much to be learned about CO2-dependent sensing and signalling. The Royal Society Publishing 12 February 2021 https://doi.org/10.1098/rsfs.2020.0033 Carbon dioxide-dependent signal transduction in mammalian systems D. E. Phelan, C. Mota, C. Lai, S. J. Kierans and E. P. Cummins
Measuring the baseline respiratory rates in confused patients seems like an easy and non invasive first step to begin searching for possible and treatable and reversible [unless you die] “hypercapnic encephalopathy”, which humans, with their fragile skeletal system, are surely at risk, throughout their lifetime.