Structural and functional organization of the respiratory center

The main experimental data on the organization of the respiratory center accumulated during the past 200 years are summarized. It is emphasized that the existence of separate, reciprocally interrelated, inspiratory and expiratory centers has never been proved. The notion of multiple respiratory centers in the CNS, including pneumotaxic, apneustic, gasping, and deep-exhalation centers, which allegedly underlie the multiple forms of respiratory movements, is demonstrated to be unjustified. Upon systemic consideration, the evidence in favor of the decisive role of neurons of the pre-Bötzinger complex and preinspiratory neurons in initiating the respiratory rhythm and maintaining rhythm generation in the respiratory center is contradictory and unconvincing. It is assumed that the respiratory center located in the medullary region of the brain of intact animals and humans fulfills the main functions of endogenous self-sustained generation of the respiratory rhythm, chemoregulation, and mechanoregulation in the respiratory system in an integrated manner, according to the general requirements of the body at a given moment.