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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01 Apr 2019
TL;DR: A good understanding of the pathogenesis and pathophysiology of OSA, OHS in respiratory failure were difficult to detect, can cause respiratory failure disease management becomes less effective and a good understanding can help with the diagnosis and management of the appropriate conduct.
Abstract: Background: Obstructive sleep apnea (OSA) is a state of the occurrence of upper airway obstruction periodically during sleep that causes breathing to stop intermittently, either complete (apnea) or partial (hipopnea) Obesity hypoventilation syndrome (OHS) is generally defined as a combination of obesity (BMI ≥ 30 kg / mc) with arterial hypercapnia while awake (PaCO2 > 45 mmHg) in the absence of other causes of hypoventilation Purpose: In order for the pulomonologis can understand the pathogenesis and pathophysiology of OSA and its complications Literature review: Several studies have been expressed about the link between OSA, OHS with respiratory failure disease Pathophysiology of OSA, OHS in respiratory failure were difficult to detect, can cause respiratory failure disease management becomes less effective Conclusion: A good understanding can help with the diagnosis and management of the appropriate conduct to prevent complications of respiratory failure associated with OSA
7 citations
TL;DR: The case of a 36-month-old boy with the classic symptoms of ROHHAD and a neuroendocrine tumor, who progressed rapidly and subsequently succumbed to cardiorespiratory arrest because of hypoventilation is presented.
Abstract: Rapid onset Obesity, Hypothalamic dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD) is a rare syndrome whose underlying pathophysiology and etiology remain elusive. We present the case of a 36-month-old boy with the classic symptoms of ROHHAD and a neuroendocrine tumor, who progressed rapidly and subsequently succumbed to cardiorespiratory arrest because of hypoventilation. His magnetic resonance imaging findings at the initial diagnosis and the brain autopsy results are detailed. The literature was reviewed to summarize the current understanding of the underlying mechanism of this rare disorder.
7 citations
01 Nov 2017
TL;DR: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a novel airway technique that utilizes high-flow humidified nasal oxygen as discussed by the authors, which can extend apnea time and maintain oxygen saturation.
Abstract: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a novel airway technique that utilizes high-flow humidified nasal oxygen. It can extend apnea time and maintain oxygen saturation. Here we report the use of THRIVE in a 35-year-old man who required emergent surgical tracheostomy for a clinically relevant compromised airway secondary to acute supraglottic and glottic pathology. Intravenous sedation resulted in hypoventilation close to apnea. THRIVE maintained oxygen saturation for 40 minutes until transient desaturation developed after complete airway obstruction.
7 citations
TL;DR: Capnography indicates partial pressure of end‐tidal carbon dioxide and provides information regarding airway integrity and patterns of ventilation compromise, and may provide an additional layer of safety, reducing risk of respiratory compromise in patients receiving procedural sedation.
Abstract: Procedural sedation is used to alleviate pain and anxiety associated with diagnostic procedures in the acute care setting. Although commonly used, procedural sedation is not without risk. Key to reducing this risk is early identification of risk factors through presedation screening and monitoring during the procedure. Electrocardiogram, respiratory rate, blood pressure, and pulse oximetry commonly are monitored. These parameters do not reliably identify airway and ventilation compromise. Capnography measures exhaled carbon dioxide and provides early identification of airway obstruction and hypoventilation. Capnography is useful in patients receiving supplemental oxygen. In these patients, oxygen desaturation reported by pulse oximetry may lag during episodes of respiratory depression and apnea. Capnography indicates partial pressure of end-tidal carbon dioxide and provides information regarding airway integrity and patterns of ventilation compromise. Implementation of this technology may provide an additional layer of safety, reducing risk of respiratory compromise in patients receiving procedural sedation.
7 citations
TL;DR: Invasive ventilation via tracheotomy represents the ultimate alternative for children with severe disease and little or no ventilatory autonomy and in patients with neuromuscular, neurological or lung disorders, non-invasive management in case of NIV failure is more challenging.
Abstract: Non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP) are effective treatments for children with severe sleep disordered breathing (SBD). However, some patients may present too severe SDB that do not respond to NIV/CPAP or insufficient compliance to treatment. A careful revaluation of the interface and of ventilator settings should be performed before considering alternative treatments. In patients with obstructive sleep apnea (OSA), alternatives to CPAP/NIV rely on the underlying disease. Ear-nose-throat (ENT) surgery such as adeno-tonsillectomy (AT), turbinectomy or supraglottoplasty represent an effective treatment in selected patients before starting CPAP/NIV and should be reconsidered in case of CPAP failure. Rapid maxillary expansion (RME) is restricted to children with OSA and a narrow palate who have little adenotonsillar tissue, or for those with residual OSA after AT. Weight loss is the first line therapy for obese children with OSA before starting CPAP and should remain a priority in the long-term. Selected patients may benefit from maxillo-facial surgery such as mandibular distraction osteogenesis (MDO) or from neurosurgery procedures like fronto-facial monobloc advancement. Nasopharyngeal airway (NPA) or high flow nasal cannula (HFNC) may constitute efficient alternatives to CPAP in selected patients. Hypoglossal nerve stimulation has been proposed in children with Down syndrome not tolerant to CPAP. Ultimately, tracheostomy represents the unique alternative in case of failure of all the above-mentioned treatments. All these treatments require a multidisciplinary approach with a personalized treatment tailored on the different diseases and sites of obstruction. In patients with neuromuscular, neurological or lung disorders, non-invasive management in case of NIV failure is more challenging. Diaphragmatic pacing has been proposed for some patients with central congenital hypoventilation syndrome (CCHS) or neurological disorders, however its experience in children is limited. Finally, invasive ventilation via tracheotomy represents again the ultimate alternative for children with severe disease and little or no ventilatory autonomy. However, ethical considerations weighting the efficacy against the burden of this treatment should be discussed before choosing this last option.
7 citations