Topic
Hypoventilation
About: Hypoventilation is a research topic. Over the lifetime, 1772 publications have been published within this topic receiving 40799 citations. The topic is also known as: respiratory depression.
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TL;DR: A greater ventilation, through voluntary hyperventilation, does not influence global or posterior cerebral blood flow during carbon dioxide breathing, and Cerebrovascular reactivity to carbon dioxide is not influenced by an individual's ventilatory sensitivity tocarbon dioxide.
Abstract: New findings What is the central question of this study? Do differing magnitudes of ventilation influence cerebrovascular CO2 reactivity and the cerebral blood flow response to increases in arterial carbon dioxide? What is the main finding and its importance? While a greater ventilation, through voluntary hyperventilation, is associated with a higher anterior cerebral blood flow during carbon dioxide breathing, this elevated cerebral blood flow is due to a higher blood pressure and not ventilation per se. A greater ventilation, through voluntary hyperventilation, does not influence global or posterior cerebral blood flow during carbon dioxide breathing. Cerebrovascular reactivity to carbon dioxide is not influenced by an individual's ventilatory sensitivity to carbon dioxide. Abstract Recent work demonstrated an influence of ventilation on cerebrovascular reactivity to CO2 ; however, the concomitant influence of changes in mean arterial blood pressure (MAP) on ventilation-induced differences in cerebral blood flow (CBF) has yet to be examined in this context. Healthy participants (n = 15; 25 ± 3 years of age; 179 ± 6 cm height; 74 ± 10 kg weight; 3 female) underwent end-tidal forcing to increase their partial pressure of end-tidal CO2 by +3, +6 and +9 mmHg above baseline in 5-min sequential steps while maintaining iso-oxia. This protocol was then repeated twice, with participants hyperventilating and hypoventilating by ∼30% compared to the first trial. Intra-cranial and extra-cranial CBF were measured using ultrasound. The MAP (finger photo-plethysmography) was higher during the hyperventilation and hypoventilation trials compared to normal ventilation (main effects, P 0.05 for all). Retrospective analysis of a larger data set (n = 53) confirmed these observations and demonstrated no relationships between the ventilatory and global CBF response to hypercapnia (r2 = 0.04; P = 0.14). Therefore, when differences in MAP are accounted for, cerebrovascular CO2 reactivity (assessed via end-tidal forcing) is independent of the magnitude of ventilation.
16 citations
01 Jan 2011
TL;DR: Management of hypoxia during one-lung ventilation is rare and often secondary to alveolar de-recruitment in the face of hypoventilation.
Abstract: One-lung ventilation (OLV) is a recognized and modifiable risk factor for acute lung injury. OLV needs to be individualized to the patient’s predicted body weight and their particular lung mechanics. Protective OLV is a combination of small, physiologic tidal volumes with consequently low ventilating pressures and routine, individualized PEEP to facilitate open lung ventilation. Ventilator-induced lung injury is preventable by minimizing driving pressure, which is a direct correlate of transpulmonary stress and strain. In patients at particular risk of lung injury, the use of permissive hypercapnia may facilitate a decrease in the mechanical strain onto the lung. Hypoxemia during one-lung ventilation is now rare and often secondary to alveolar de-recruitment in the face of hypoventilation. Management of hypoxemia requires a structured treatment algorithm.
16 citations
TL;DR: ROHHAD is highly unlikely to be caused by mutations in the exons of the genes for hypocretin and its two receptors, as reported in a recent case report.
16 citations
TL;DR: Rapid improvement following abortion suggests that increased bronchomotor tone predominated inflammatory changes in causing flow limitation in a 19-year-old woman admitted with acute severe asthma.
Abstract: A 19-year-old woman was admitted with acute severe asthma in her eleventh week of pregnancy. Despite vigorous therapy, severe hypoventilation and hypoxemia persisted with mechanical ventilation. Termination of pregnancy resulted in dramatic improvement in airflow. Her course was complicated by pneumonia, barotrauma, and atelectasis accompanying her moribund state. Although she immediately improved following abortion (within 2 hr, peak airway pressure fell from > 70 to 38 cmH2O, without change in plateau pressure), superimposed morbidities improved more slowly, and the patient made a complete recovery. The mechanism accounting for this observation is unknown but the rapid improvement following abortion suggests that increased bronchomotor tone predominated inflammatory changes in causing flow limitation.
16 citations
TL;DR: It is concluded that heart rate control, but not ventilatory control, is sensitive to relatively small increases in hydrostatic pressure.
Abstract: We sought to determine whether hydrostatic pressure contributed to bradycardia and hypoventilation in hyperbaria. Eight men were studied during exercise at 50, 150, and 250 W while breathing 1) air...
16 citations