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.

Postoperative massive collapse of the lungs.

Abstract: Two patients have been encountered who died immediately after operation with pulmonary collapse. Each patient underwent a prolonged operation to correct esophageal obstruction and then suffered severe hypoventilation and died before adequate resuscitative measures could be instituted. The literature was reviewed for previous clinical reports of this syndrome as well as reports of experimental work that has been done to determine the etiology of massive atelectasis. The combination of respiratory depression, rapid absorption of gas from the alveoli, and bronchospasm secondary to vagus nerve reflexes was responsible for the production of massive pulmonary collapse. To prevent this complication, repeated doses of atropine during surgery, hyperventilation with room air at the end of anesthesia, and mechanical respiratory assistance in selected cases are suggested.

ROHHAD syndrome - A still unrecognized cause of childhood obesity: report of three cases.

Abstract: Objectives Rapid-onset obesity with hypoventilation, hypothalamic dysfunction, and autonomic dysregulation (ROHHAD) is a rare, potentially fatal, pediatric syndrome. Case presentations We describe three cases of ROHHAD-syndrome in Greece. The main and earliest symptom was the excessive and rapid weight gain at 5, 2, and 3 years of age. Years after the onset of obesity, the patients developed hypothalamic dysfunction with various endocrinological abnormalities (at 9, 8, and 6.8 years, respectively), autonomic dysregulation and finally, alveolar hypoventilation (at 14.6, 8, and 7.8 years, respectively), leading to the diagnosis of ROHHAD-syndrome. Conclusions The rarity of the syndrome, the variable symptoms' presentation, and the lack of specific diagnostic tests could explain why no previous cases have been reported from our country. The rapid onset of obesity was underestimated, and the patients were misdiagnosed with other more common obesity syndromes. Therefore, we propose a questionnaire to help physicians identify patients with ROHHAD-syndrome.

[Myxedema coma in a patient with type 1 neurofibromatosis: rare association].

Abstract: Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

Use of a new generation of adaptive servo ventilation for sleep-disordered breathing in patients with multiple system atrophy.

Abstract: A 70-year-old man (case 1) and a 64-year-old woman (case 2) with multiple system atrophy (MSA) and snoring were admitted for polysomnography. Their awake PaCO2 indicated normocapnia. Apnoea–hypopnoea index (AHI), max transcutaneous carbon dioxide partial pressure (PtcCO2) and ΔPtcCO2 (max PtcCO2 (during sleep)—baseline PtcCO2 (while awake)) were 11.4/h, 63 mm Hg and 18 mm Hg, respectively, in case 1 and 53.1/h, 59 mm Hg and 13 mm Hg, respectively, in case 2. Their sleep-disordered breathing (SDB) was diagnosed as obstructive sleep apnoea with hypoventilation. We thought that variable expiratory positive airway pressure and pressure support ventilation (advanced-adaptive servo ventilation (ASV)) might be favourable for their SDB. Polysomnography after introducing advanced-ASV revealed that AHI, max PtcCO2 and ΔPtcCO2 were 0.2/h, 53 mm Hg and 5 mm Hg, respectively, in case 1 and 1.5/h, 56 mm Hg and 9 mm Hg, respectively, in case 2. Advanced-ASV for treating Cheyne-Stokes breathing may be helpful in SDB in patients with MSA.

Effect of intraventricular hemorrhage on pulmonary function in newborn piglets.

Abstract: Intracranial hemorrhage in the premature infant is often associated with respiratory failure and need for mechanical ventilation. We therefore addressed the question of possible interactions with and pulmonary consequences of intraventricular hemorrhage. Newborn piglets were studied during intraventricular hemorrhage simulated by intraventricular blood infusion. Infusion volume amounted to 8% of estimated brain weight. Respiratory rate, minute ventilation, lung resistance and dynamic lung compliance, as well as arterial blood gases, arterial and intraventricular pressures were measured. The piglets were mechanically ventilated with a low basal rate of 20 breaths per minute throughout the study. All piglets experienced significant rise in intraventricular pressure and respiratory failure during the study. Respiratory failure was mainly a result of a reduction in respiratory frequency and minute ventilation until apnea. However, a rise in lung resistance was also noted while lung compliance did not change. We conclude that increased need for mechanical ventilation during intracranial hemorrhage is primarilty a consequence of hypoventilation. The increase seen in lung resistance could also suggest that intraventricular hemorrhage causes an element of bronchiolar constriction. Furthermore, these effects are not only a result of the increase in intraventricular pressure, but specific effects of blood components within the central nervous system must be considered.