Showing papers on "Hypoventilation published in 1986"

Low acute hypoxic ventilatory response and hypoxic depression in acute altitude sickness.

Abstract: Persons with acute altitude sickness hypoventilate at high altitude compared with persons without symptoms. We hypothesized that their hypoventilation was due to low initial hypoxic ventilatory res...

Oculocardiac reflex and the anesthesiologist.

Abstract: Oculocardiac reflex is one of the trigemino-vagal reflexes, and is frequently observed during anesthesia for pediatric strabismus surgery. The reflex is greatly exaggerated in the presence of hypoventilation, hypoxemia and acidosis. The reflex is important as a cause of cardiac arrest during eye surgery. Several related reflexes are known, such as blepharocardiac reflex, oculorespiratory reflex, and the sudden infant death syndrome. Although the reflex can be prevented by a retrobulbar block or the administration of parasympatholytic drugs, well conducted anesthesia and cooperation with the surgeon is much more important.

Clinical applications of mechanical ventilation.

Abstract: This paper reviews recent applications of mechanical ventilation such as controlled hypoventilation in acute asthma, domiciliary nocturnal ventilation in chronic respiratory failure due to neuromuscular disease and improvement of left ventricular performance by raised intrathoracic pressure. Established uses of mechanical ventilation include control of respiratory failure, intracranial pressure and pulmonary hypertension while other uses such as internal splinting of flail chest, simultaneous ventilation-compression cardiopulmonary resuscitation and prophylactic postoperative ventilation are more controversial.

The cardiopulmonary failure of sleep-disordered breathing.

Abstract: SLIGHTLY more than 100 years following the publication of thePick-wick Papers, wherein Charles Dickens described the hypersomnolent and obese character Joe, the termpickwickian syndromewas applied to a group of patients exhibiting obesity, hypersomnolence, hypoventilation, and erythrocytosis.1Since this descriptive report, a large amount of information regarding the clinical spectrum, pathophysiology, and treatment of various forms of sleep-induced breathing disorders has been generated,2requiring increased clinical awareness of methods of diagnosis and treatment. Sleep-induced breathing disorders include the following: sleep apnea syndromes, such as central, obstructive, and mixed apnea; primary alveolar hypoventilation; periodic or irregular breathing patterns; and nocturnal hypoxemia in chronic obstructive pulmonary disease (COPD) or neuromuscular disorders (NMD). Apneas are defined as the complete cessation of ventilation and may be analyzed bypolysomnography3—the simultaneous recording during sleep of an electroencephalogram (to characterize sleep stage and pattern), measures of airflow (by means of

Marked hypochloremic metabolic alkalosis with severe compensatory hypoventilation.

Abstract: In metabolic alkalosis, a compensatory decrease in alveolar ventilation with hypercapnia has been noted only rarely. We recently managed a patient with gastric outlet obstruction from a duodenal ulcer who survived after arriving in the emergency room comatose with severe hypochloremic metabolic alkalosis, compensatory hypoventilation, and hypercapnia. We know of no report in the English literature of a patient with gastric outlet obstruction having a respiratory acidosis or hypochloremia as severe as that in our patient. Proper understanding of the pathophysiology of primary metabolic alkalosis due to gastric losses is necessary to correct the acid-base abnormalities quickly and to restore normal alveolar ventilation.

Control of Breathing in Diseases of the Respiratory Tract and Lungs

Abstract: The sections in this article are: 1 Dyspnea 2 Resistive Loads and Airway Obstruction 2.1 Definition 2.2 Disease States 2.3 Extrinsic Resistive Loading as a Model of Airway Obstruction 2.4 Effect of Administration of O2-Enriched Mixtures in Hypercapnic COPD Patients 2.5 Strength and Endurance of Respiratory Muscles 3 Elastic Loads and Lung Restriction 3.1 Definition 3.2 Diseases of Increased Elastic Loading 3.3 Patterns of Breathing in Diseases of Elastic Loading 3.4 Lung Restriction With Hyperventilation 4 Pulmonary Vascular Diseases 5 Chest Wall Elastic Loading with Adequate Alveolar Ventilation 6 Lung and Chest Wall Restriction with Hypoventilation

Controversies in sleep-related breathing disorders.

Abstract: This review addresses some current controversies and issues of interest in sleep-related disorders of breathing. Abnormalities of respiratory control may influence the degree of obstructive sleep apnea but it is likely that abnormalities of pharyngeal size are of far greater significance. Central sleep apnea is a heterogeneous condition. Examples of all the causes one would postulate leading to cessation of drives to breathe do occur, hence appropriate therapies also vary. It is not yet known what aspect of, and how much, disordered breathing during sleep leads to morbidity, thus fixed definitions of normality are not helpful. Recurrent nocturnal asphyxia alone is unlikely to result in chronic respiratory failure. Associated diffuse airways obstruction or impaired respiratory muscle function is probably necessary before this complication arises. The recurent REM sleep-induced dips of Sao2 in patients with chronic airways obstruction may be due to physiological inhibition of accessory muscles of respiration. This leads to considerable hypoventilation and recurrent activation of an intact, but displaced, hypoxic drive, resulting in the characteristic oscillations of Sao2.

Respiratory dysrhythmia. A new cause of central alveolar hypoventilation.

Abstract: An infant developed chronic respiratory failure after aseptic meningoencephalitis at 5 months of age. Neurologic evaluations at 16 and 17 months were normal except for an abnormal pharyngeal stage of swallowing, lower extremity hypotonia, and a mild left hemiparesis. Spontaneous breathing during sleep at 16 months was characterized by alveolar hypoventilation, athetoid truncal movements, and disorganized respiratory muscle activity. At 27 months of age, improvement in sleep-related breathing was accompanied by a change in respiratory pattern characterized by alternating inspiratory and expiratory muscular activation. The findings indicate that disorganized as well as diminished output from the central respiratory pattern generator may result in central alveolar hypoventilation.

Hypoventilation during hemodialysis.

Abstract: M.E. De Broe, MD, PhD, Department of Nephrology-Hypertension, University Hospital Antwerp, Wilrijkstr. 10, B-2520 Edegem (Belgium) Dear Sir, Methods In a recent article in this journal [1], Faro et al. studied the influence of C02 changes, due to Co2 extraction during acetate dialysis, on the central venous blood composition and their effect on the pulmonary ventilation. They postulated that the decrease in C02 in the venous line blood has influence on the central venous blood composition, and that this plays a role in the control of the pulmonary ventilation in these patients. In this communication we present our results on the influence of C02 loss through the dialyzer on the carbon dioxide tension measured in the pulmonary artery (mixed venous blood). Ten patients, mean age 54,7 years (24–72 years), 6 male and 4 female, undergoing 4-hour maintenance hemodialysis sessions three times weekly, were studied. Nine patients were studied during hemodynamic monitoring for evaluation of different cardiac problems. They were all critically ill at the time of the study and treated with oxygen through a nasal cannula. One male patient volunteered to participate in the study. All patients gave informed consent. The patients were dialyzed with acetate-containing dialysate and a single-needle, double-headed pump system. A Swan-Ganz thermodilution catheter (93A-131H-7F; Edwards Laboratory, Santa Anna, Calif., USA) was introduced percutane-ously through the internal jugular vein into the pulmonary artery, at least 15 min before the start of the first measurement. Blood samples were drawn from the pulmonary artery and from the arterial side of

Respiratory, haemodynamic and haematologic characteristics in two patients with myxoedema coma and hypothermia.

Abstract: SummaryManagement of myxocdcma coma is complex. Thyroid hormone replacement must be combined with other supportive measures: reestablishment of the airway, mechanical ventilation in the ease of hypoventilation combined with hypercapnia and hypoxia, and continuous cardiovascular monitoring to avoid cardiac failure and myocardial ischemia.I lypothermia is commonly present in myxocdcma coma and complicates the treatment. An understanding of the pathophysiological consequences of hypothermia is important for the management of these patients.Although no studies have been performed on the laryngeal complications of intubated patients with myxocdcma coma, our work suggests that particular care should be taken during intubation of these patients.Clinique Saint Cumillc. Service Soins Intensify Avenue Albert I. 5IMH) Namur. Belgium

Regulation of respiration during sleep in congenital central sleep apnea

Abstract: We report on 2 children aged 13 and 14 months with congenital central alveolar sleep apnea which showed depression of respiratory drive during sleep resulting from dysfunction of central chemoreceptors. Hypoventilation was found to be more severe during NREM sleep (minimum of alveolar ventilation in stages 3/4) than during REM sleep. During NREM sleep arousal responses to hypoxia proved to be an important factor in influencing the level of alveolar ventilation and in preventing fatal asphyxia.