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: The detection of hypoventilation, oxygen desaturation, and obstructive sleep apnea may lead to more effective treatment of patients with chronic obstructive pulmonary disease, kyphoscoliosis, and neuromuscular disorders.
Abstract: Patients with chronic obstructive pulmonary disease, kyphoscoliosis, and neuromuscular disorders frequently desaturate in rapid eye movement sleep. This can lead to polycythemia, pulmonary hypertension, and respiratory failure. In addition, these patients as well as those with asthma may have unsuspected coexistent obstructive sleep apnea. The detection of hypoventilation, oxygen desaturation, and obstructive sleep apnea may lead to more effective treatment of these patients.
10 citations
TL;DR: The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features and review and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor.
Abstract: Patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may remain undiagnosed and untreated with immunotherapy. To investigate specific features and responses to immunotherapy of atypical anti-NMDAR antibody positivity patients, the authors reviewed and evaluated previous case reports/series including patients without seizure, involuntary movement, hypoventilation, or tumor. Of 22 patients identified, 21 responded to immunotherapy. Two patients had neurological/motor symptoms with few/no psychiatric/cognitive symptoms, and eight had both. Twelve patients presented with psychiatric/cognitive symptoms with few/no neurological/motor symptoms, and ≥1 had memory impairment, catatonia, abnormal MRI or electroencephalogram results. The authors recommend lumbar puncture and examination of anti-NMDAR antibodies for patients with these features.
10 citations
23 Feb 2016
TL;DR: Patients with obesity hypoventilation syndrome have poor quality of life and are at great risk for excess hospitalization and premature mortality because of cardiopulmonary complications including exacerbation of respiratory and congestive heart failure.
Abstract: Obesity is a highly prevalent disorder associated with excess healthcare cost and multiple medical complications. Two major respiratory consequences of obesity are obstructive sleep apnoea and obesity hypoventilation syndrome, which are sometimes comorbid. This comorbidity of obstructive sleep apnoea and obesity hypoventilation most commonly manifest in morbidly obese individuals. However, a small number of patients with the syndrome do not suffer from comorbid obstructive sleep apnoea. Meanwhile, these two phenotypes of obesity hypoventilation syndrome are clinically indistinguishable from each other. Patients with obesity hypoventilation syndrome have poor quality of life and are at great risk for excess hospitalization and premature mortality because of cardiopulmonary complications including exacerbation of respiratory and congestive heart failure. Not surprisingly, long-term management of patients with obesity hypoventilation syndrome is associated with excess healthcare cost as well.
10 citations
TL;DR: Apnea is known to occur during seizures, but systematic studies of ictal respiratory changes in adults are few, and data regarding respiratory pattern defects during interictal periods also are scarce.
Abstract: Summary: Purpose: Apnea is known to occur during seizures, but systematic studies of ictal respiratory changes in adults are few. Data regarding respiratory pattern defects during interictal periods also are scarce. Here we sought to generate information with regard to the interictal period in animals with pilocarpine-induced epilepsy.
Methods: Twelve rats (six chronically epileptic animals and six controls) were anesthetized, given tracheotomies, and subjected to hyperventilation or hypoventilation conditions. Breathing movements caused changes in thoracic volume and forced air to flow tidally through a pneumotachograph. This flow was measured by using a differential pressure transducer, passed through a polygraph, and from this to a computer with custom software that derived ventilation (VE), tidal volume (VT), inspiratory time (TI), expiratory time (TE), breathing frequency (f), and mean inspiratory flow (VT/TI) on a breath-by-breath basis.
Results: The hyperventilation maneuver caused a decrease in spontaneous ventilation in pilocarpine-treated and control rats. Although VE had a similar decrease in both groups, in the epileptic group, the decrease in VE was due to a significant (p < 0.05) increase in TE peak in relation to that of the control animals. The hypoventilation maneuver led to an increase in the arterial Paco2, followed by an increase in VE. In the epileptic group, the increase in VE was mediated by a significant (p < 0.05) decrease in TE peak compared with the control group. Systemic application of KCN, to evaluate the effects of peripheral chemoreception activation on ventilation, led to a similar increase in VE for both groups.
Conclusions: The data indicate that pilocarpine-treated animals have an altered ability to react to (or compensate for) blood gas changes with changes in ventilation and suggest that it is centrally determined. We speculate on the possible relation of the current findings on treating different epilepsy-associated conditions.
10 citations
01 Jan 2019
TL;DR: The physiology of prematurity as it relates to anesthesia is of particular importance when preparing for surgery, because the liver and kidneys are underdeveloped, leading to altered drug metabolism, thus, anesthetic drugs must be tailored accordingly.
Abstract: The preterm infant, defined as birth before 37 weeks gestation, provides unique medical and surgical challenges to health care providers due to a myriad of anatomical underdevelopments and physiologic derangements. The physiology of prematurity as it relates to anesthesia is of particular importance when preparing for surgery. Anatomic differences of the premature airway and altered respiratory mechanics, such as a smaller airway diameter, increased oxygen consumption, bronchopulmonary dysplasia and apnea place these infants at risk for rapid and profound desaturation and hypoventilation during anesthesia. The immature heart has not had time to develop sufficient muscle fibers for optimal contractility. In addition, persistent pulmonary hypertension of the newborn may develop when right-to-left shunting of blood occurs through a patent ductus arteriosus and/or a patent foramen ovale due to failure of the pulmonary vascular resistance to drop at birth. These factors may combine and lead to significant cardiovascular collapse during surgery. Premature infants are susceptible to metabolic derangements such as hypoglycemia and hypocalcemia due to improper storage and loss of maternal-fetal transfer during gestation. The liver and kidneys are underdeveloped, leading to altered drug metabolism, thus, anesthetic drugs must be tailored accordingly. Neonatal surgical emergencies, such as congenital diaphragmatic hernia, hypertrophic pyloric stenosis, necrotizing enterocolitis and gastroschisis, can present at any time and be life-threatening. Immediate surgical intervention is not always necessary and there is often time for medical optimization. Advances in neonatal care have improved the morbidity and mortality of critically ill newborns.
10 citations