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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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Journal ArticleDOI
TL;DR: Clinicians might exercise caution to consider potential pitfalls of therapeutic errors in patients with obesity hypoventilation to avoid inflicting unintended and avoidable complications.
Abstract: The prevalence of obesity hypoventilation syndrome and obstructive sleep apnea are increasing rapidly in the United States in parallel with the obesity epidemic. As the pathogenesis of this chronic illness is better understood, effective evidence-based therapies are being deployed to reduce morbidity and mortality. Nevertheless, patients with obesity hypoventilation still fall prey to at least four avoidable types of therapeutic errors, especially at the time of hospitalization for respiratory or cardiovascular decompensation: (1) patients with obesity hypoventilation syndrome may develop acute hypercapnia in response to administration of excessive supplemental oxygen; (2) excessive diuresis for peripheral edema using a loop diuretic such as furosemide exacerbates metabolic alkalosis, thereby worsening daytime hypoventilation and hypoxemia; (3) excessive or premature pharmacological treatment of psychiatric illnesses can exacerbate sleep-disordered breathing and worsen hypercapnia, thereby exacerbating psychiatric symptoms; and (4) clinicians often erroneously diagnose obstructive lung disease in patients with obesity hypoventilation, thereby exposing them to unnecessary and potentially harmful medications, including β-agonists and corticosteroids. Just as literary descriptions of pickwickian syndrome have given way to greater understanding of the pathophysiology of obesity hypoventilation, clinicians might exercise caution to consider these potential pitfalls and thus avoid inflicting unintended and avoidable complications.

28 citations

Journal Article
TL;DR: The goal is to provide adequate gas exchange while minimizing hyperinflation and ventilator-induced lung injury and administering aggressive therapy to reduce airway inflammation and bronchoconstriction.
Abstract: Despite recent advances in our ability to manage asthma, there continues to be a small but important incidence of patients who present with severe asthma exacerbations that require ventilatory support. Mechanical ventilation in these patients is difficult and can be associated with substantial morbidity. Unfortunately, there is little in the way of randomized controlled trials to guide our therapeutic decisions in these patients. The goal is to provide adequate gas exchange while minimizing hyperinflation and ventilator-induced lung injury and administering aggressive therapy to reduce airway inflammation and bronchoconstriction. Although there is controversy on exactly what is the optimal method for mechanical ventilation in asthma, most experts agree that a general approach based on controlled hypoventilation is ideal.

28 citations

Journal ArticleDOI
TL;DR: Bilateral anterior nasal pack results in hypoxia and hypercapnia due to hypoventilation and a significant increase of percentage of Hb is suggested.
Abstract: Arterial blood samples were taken from adult healthy patients before and 24 hours after bilateral nasal packing. The blood samples were investigated for PO2, PCO2, HCO3, pH and Hb. It was found that there is (i) an increase of high significance of PCO2 and HCO3-, (ii)) a significant increase of percentage of Hb., (iii) a highly significant decrease of PO2 in patients after nasal packing; (iv) as regards the pH, no significant difference was found. What we suggest is that bilateral anterior nasal pack results in hypoxia and hypercapnia due to hypoventilation.

28 citations

Journal ArticleDOI
TL;DR: Individuals with SCI experience hypoventilation at sleep onset, which cannot be explained by upper airway mechanics, and this may contribute to the development of sleep‐disordered breathing in the SCI population.
Abstract: A high prevalence of sleep-disordered breathing (SDB) after spinal cord injury (SCI) has been reported in the literature; however, the underlying mechanisms are not well understood. We sought to determine the effect of the withdrawal of the wakefulness drive to breathe on the degree of hypoventilation in SCI patients and able-bodied controls. We studied 18 subjects with chronic cervical and thoracic SCI (10 cervical, 8 thoracic SCI; 11 males; age 42.4 ± 17.1 years; body mass index 26.3 ± 4.8 kg/m2) and 17 matched able-bodied subjects. Subjects underwent polysomnography, which included quantitative measurement of ventilation, timing, and upper airway resistance (RUA) on a breath-by-breath basis during transitions from wake to stage N1 sleep. Compared to able-bodied controls, SCI subjects had a significantly greater reduction in tidal volume during the transition from wake to N1 sleep (from 0.51 ± 0.21 to 0.32 ± 0.10 L vs. 0.47 ± 0.13 to 0.43 ± 0.12 L; respectively, P < 0.05). Moreover, end-tidal CO2 and end-tidal O2 were significantly altered from wake to sleep in SCI (38.9 ± 2.7 mmHg vs. 40.6 ± 3.4 mmHg; 94.1 ± 7.1 mmHg vs. 91.2 ± 8.3 mmHg; respectively, P < 0.05), but not in able-bodied controls (39.5 ± 3.2 mmHg vs. 39.9 ± 3.2 mmHg; 99.4 ± 5.4 mmHg vs. 98.9 ± 6.1 mmHg; respectively, P = ns). RUA was not significantly altered in either group. In conclusion, individuals with SCI experience hypoventilation at sleep onset, which cannot be explained by upper airway mechanics. Sleep onset hypoventilation may contribute to the development SDB in the SCI population.

28 citations

Journal ArticleDOI
TL;DR: Improved case identification of children with upper airway obstruction during sleep should result if physicians are aware of such signs and symptoms as excessive daytime sleepiness, loud snoring, restless sleep, recurrent nocturnal enuresis, systemic and pulmonary hypertension, undergrowth or obesity, and cor pulmonale.

28 citations


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Performance
Metrics
No. of papers in the topic in previous years
YearPapers
2023114
2022173
202173
202071
201949
201860