Find A BIBH Practitioner
Buteyko Institute (BIBH)
Buteyko Method
Latest News
Scientific Research
Media Articles
Sleep Apnoea
Other Conditions
Practitioner Training
Practitioner Trainers
Buteyko Institute Trust
Buteyko Institute Gift Fund
Policy Documents
Members Area
Contact Us

Research Clinical Trials Clinical Trials      
Scientific Research
Clinical Trials Report or Abstract

Clinical Trials and Research undertaken into the Buteyko Method and related issues.

Ventilation Test In Patients With Bronchial Asthma
Source: Buteiko KP, Odintsova MP, Nasonkina NS. Vrach Delo. 1968 Apr; 4:33-6. PMID: 5664602 [PubMed - indexed for MEDLINE]

* Translated by: Tamer Y. EL MAYS, MD. Cardiovascular/Respiratory Sciences, Faculty of Medicine, University of Calgary. 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1
Tel:(403)220-3044, Fax:(403)270-8928, E-mail: mtyel@ucalgary.ca

Experiments on animals showed the influence of carbonic acid (gas) in inhaled air on bronchial tone (Broun, 1885; Lor, 1924; Tienze, 1929; Peter, 1955 and others). Lloyd (1963) established in healthy individuals a negative dependence between the degree of bronchial constriction and the level of CO2 in alveoli.

According to the data of several investigators on patients with bronchial asthma in periods of exacerbation of the disease, an increase in pulmonary ventilation was observed (A. I. Dziuba, 1963; P. K. Bulatov, 1964 and others). Increased pulmonary ventilation without changes in the main exchange should result in decreased pCO2 in alveoli. That is why an interest arises in studying in patients with bronchial asthma, the dependence of bronchial tone on the pulmonary ventilation and partial pressure of carbonic acid (gas) in alveoli (pCO2A).

Investigating 44 patients with bronchial asthma during exacerbation and without exacerbation, age from 10 to 70 year, 15 men, 29 women, duration of the disease from 3 to 20 years.

Patients underwent tests in which they voluntarily increased pulmonary ventilation during 1 to 3 minutes until the appearance of negative symptoms. Then they decreased depth and frequency of their breathing until disappearance of the negative symptoms that resulted from hyperventilation. During the test, 22 patients had a non-stop recording of carbopneumograms (partial pressure of carbonic acid (gas) in alveoli pCO2A) on a “capnograph” from “Godart” company, and pneumotachograms. pCO2A was determined every 10 seconds, as well as the gain of pCO2A along the alveolar plateau of the carbopneumogram per 1 sec. (ΔpCO2A mmHg/sec., which can characterize irregularity of alveolar ventilation, depending on narrowing of bronchial opening in several parts), respiratory frequency, tidal volume, minute ventilation. In all patients, subjective symptoms and the time of their onset were taken into consideration. The dynamics of indicators of external breathing and pCO2A are reflected in table 1.

Table 1:
Measurement indicators Unit of measurement Initial values Test with hyperventilation Test with decreased ventilation
Respiratory frequency Per 1min 16 22 13.5
Tidal volume L 0.523 0.764 0.430
Minute ventilation L/min 8.324 23.220 5.620
pCO2A mmHg 36.3 26 29
ΔpCO2A mmHg/sec 5.9 6.4 4.84

Initial values: pCO2A = 36.3 mmHg, respiratory frequency = 16/min, tidal volume = 0.523L, minute ventilation = 8.324 L/min, Δ pCO2A = 5.9 mmHg/sec.

As a result of hyperventilation (mean duration of the tests : 1min.45sec) pCO2A dropped to 26 mmHg, respiratory frequency increased to 22/min, tidal volume to 0.764 L, minute ventilation to 23.22L/min, Δ pCO2A to 6.4 mmHg/sec. In 32 of 44 persons in an average of 105 seconds after the beginning of hyperventilation, several signs of bronchospasm appeared (dyspnoea, wheezes, breathlessness, and cough). Besides bronchospasm symptoms 11people had headache, ten had dizziness, five had pain in the heart region, two had palpitation, one had weakness, and one had numbness of fingers.

As a result of reduced pulmonary ventilation pCO2A increased to 29 mmHg, respiratory frequency decreased to 13.5/min, tidal volume to 0.430 L, minute ventilation to 5.620 L/min, Δ pCO2A to 4.84 mmHg/sec. symptoms of bronchospasm disappeared in all patients within an average duration of 105 seconds.

Besides the above-mentioned indicators, in 18 patients, using the pneumotachograph, and by means of overlapping air stream at the pitch of inspiration and expiration bronchial resistance was defined. The resistance of bronchial tree (R) was determined by the formula P/V, where P is the pressure in the bronchi at the overlapping moment, V is the velocity of air movement at the moment of overlapping.

Conducting cross-correlative analysis (K. P. Buteyko, D. V. Demin, 1963) interconnects pCO2A with Δ pCO2A mmHg/sec. and R on inspiration and expiration for each one investigated.

Cross-correlation between pCO2A and R on inspiration was calculated in 11 people. Positive correlation was obtained in four people. The average coefficient of correlation (r) was equal to 0.67 (from 0.32 to 0.75), the response time of bronchial resistance in response to changes in CO2 (t) was on average equal to 45sec. (from 30 to 70 sec.). Negative correlation was obtained in six people, r = -0.49 (from -0.36 to -0.80), t = 73 sec. (from 20 to 210 sec.). One patient did not show clear correlation.

Correlation between pCO2A and R on expiration was calculated in 17 people. Positive correlation was obtained in nine people: r = 0.53 (from 0.11 to 0.87); t = 57.7 sec. (from 20 to 120 sec.), negative correlation was obtained in eight people: r = -0.40 (from -0.80 to -0.89), t = 98.7 sec. (from 30 to 220 sec.).

Correlation between pCO2A and Δ pCO2A was calculated in 16 people: positive correlation was obtained in six: r = 0.50 (from 0.15 to 0.78), t = 75 sec. (from 20 to 230 sec.), negative correlation was obtained in nine: r = -0.43 (from -0.16 to -0.92), t = 44.4 sec. (from 20 to 90 sec.), clear correlation was not determined in two patients.

Thus, hyperventilation, decreasing pCO2 in alveoli, led to increased irregularities of pulmonary ventilation (Δ pCO2A) and to the appearance of some or other symptoms of bronchospasm in the majority of the patients. Decreased pulmonary ventilation resulted in decreased irregularities of alveolar ventilation (Δ pCO2A) and disappearance of symptoms of bronchospasm that appeared during hyperventilation in all patients.

In the majority of patients (in six of ten) with clear cross-correlation, negative dependence was obtained between the level of pCO2A and the resistance of bronchial tree on inspiration and between the ventilatory irregularities’ indicators (Δ pCO2A) and pCO2A (in nine of fifteen), which indicate a rise in bronchospasm in the majority of patients upon decreased pCO2A during hyperventilation.


1. Hyperventilation, decreasing pCO2 in alveolar air, in patients with bronchial asthma in exacerbation period, lead to increase alveolar ventilation’s irregularities and the appearance of bronchospasm symptoms in the majority of them.
2. Decreased pulmonary ventilation lead to decrease irregularities of alveolar ventilation and disappearance of bronchospasm’ symptoms that resulted from hyperventilation.
3. In the majority of patients with clear cross-correlation, negative dependence was determined between the level of partial pressure of CO2 in alveoli and the resistance of bronchial tree on inspiration; as well as between partial pressure of CO2 in alveoli and irregularity of pulmonary ventilation (Δ pCO2A).

More Clinical Trials

Breathing exercises for asthma: a randomised controlled trial
Thorax 2009; 64:55-61 [Abstract] [Full Text]

A Randomised Controlled Trial of the Buteyko Technique for Asthma Management
Respiratory Medicine May 2008 (Vol. 102, Issue 5, Pages 726-732) [Abstract] [Full Text]

Canadian Buteyko Trial 2008

Beta-agonists trigger T cell accumulation
J Allergy Clin Immunol 2006 [Abstract]

Asthma exacerbations in children immediately following stressful life events: a Cox's heirarchical regression
S Sandberg, S Jarvenpaa, A Penttinen, J Y Paton, and D C McCann Thorax 2004;59 1046-1051 [Abstract] [Full Text]

Ventilation Test In Patients With Bronchial Asthma
Buteiko KP, Odintsova MP, Nasonkina NS. Vrach Delo. 1968 Apr; 4:33-6. PMID: 5664602 [PubMed - indexed for MEDLINE] [Abstract]

Obstructive Sleep Apnoea and breathing retraining
Mary Birch, RN,BA,MBioE, Grad Dip Soc, BIBHClinical Update 74, Australian Nursing Journal, August 2004 [Text]

Buteyko Breathing Technique for asthma: an effective intervention
Patrick McHugh, Fergus Aitcheson, Bruce Duncan, Frank Houghton Journal of the New Zealand Medical Association, 12-December-2003, Vol 116 No 1187 [Abstract] [Full Text]

Health Education: Does the Buteyko Institute Method make a difference?
Jill McGowan, Education and training consultant in Asthma Management.Thorax Vol 58, suppl III, page 28, December 2003. [Abstract] [Full Text]

Beta2-Agonist Tolerance and Exercise-induced Bronchospasm
Am. J. Respir. Crit. Care Med., Volume 165, Number 8, April 2002, 1068-1070 Robert J. Hancox, Padmaja Subbarao, Dennis Kamada, Richard M. Watson, Fredrick E. Hargreave, and Mark D. Inman Asthma Research Group, Firestone Institute for Respiratory Health, McMaster University/St Joseph's Hospital, Hamilton, Ontario, Canada  [Abstract]

End-tidal carbon dioxide measurements as a prognostic indicator of outcome in cardiac arrest.
Ahrens T, Schallom L, Bettorf K, Ellner S, Hurt G, O'Mara V, Ludwig J, George W, Marino T, Shannon W. Barnes-Jewish Hospital, St. Louis, MO, USA. Am J Crit Care 2001 Nov;10(6):391-8 [Abstract]

Repeated Hyperventilation Causes Peripheral Airways Inflammation, Hyperreactivity, and Impaired Bronchodilation in Dogs
MICHAEL S. DAVIS and ARTHUR N. FREED Am. J. Respir. Crit. Care Med., Volume 164, Number 5, September 2001, 785-789 [Abstract]

Cardiovascular side effects of inhaled salbutamol in hypoxic asthmatic patients
Thorax; London; Jul 2001; J Burggraaf; R G J Westendorp; J C C M In't Veen; R C Schoemaker; et al;  [Abstract]

Study explains success of Buteyko
Megan Howe - Australian Doctor, p 20, 11 May 2001 [Text]

Prevalence of dysfunctional breathing in patients treated for asthma in primary care: a cross sectional survey
M Thomas, RK McKinley, E Freeman, C Foy British Medical Journal 2001;322:1098-1100 (5 May) [Abstract]

Hyperventilation and asymptomatic chronic asthma
Thorax; London; Dec 2000; C A Osborne; B J O'Connor; A Lewis; Van Kanabar; W N Gardner; [Abstract]

Buteyko breathing techniques in asthma: a blinded randomised trial
Simon D Bowler, Amanda Green and Charles A Mitchell Medical Journal of Australia 1998; 169:575-578 [Abstract] [Full Text]

Effects of inhaled CO2 and added dead space on idiopathic central sleep apnea
Xje A. Rankin F. Rutherford R. Bradly TD. Journal of Applied Physiology, 82(3):918-26, 1997 Mar. [Abstract]

Changing patterns in asthma morbidity and mortality.
Sears MR J-Investig-Allergol-Clin-Immunol 1995 Mar-Apr; 5(2): 66-72.  [Abstract]

Beneficial effect of inhaled CO2 in a patient with non-obstructive sleep apnoea.
J Neurol 1993 Nov;241(11:45-8 (ISSN: C340-5354) Villiger PM; Hess CW; Reinhart WH Medizinische Klinik der Universitat, Inselspital, Bern, Switzerland [Abstract]

Rediscovering the importance of nasal breathing in sleep or, shut your mouth and save your sleep
Lavie P J Layngol Otol 1987 June;101(6):558-63 [Abstract]

Breathing Patterns
Chest, 1983, 84:202-205Tobin et al (Summary) [Abstract]

Home | Find A BIBH Practitioner | Buteyko Institute (BIBH) | Buteyko Method | Latest News | Scientific Research | Media Articles | Asthma | Sleep Apnoea | Other Conditions | Membership | Practitioner Training | Practitioner Trainers | Buteyko Institute Trust | Buteyko Institute Gift Fund | Policy Documents | Members Area | Contact Us | Search