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Hypoventilation

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https://www.readbyqxmd.com/read/28644040/hypoxic-pulmonary-vasoconstriction-does-not-explain-all-regional-perfusion-redistribution-in-asthma
#1
Vanessa J Kelly, Kathryn A Hibbert, Puja Kohli, Mamary Kone, Elliot E Greenblatt, Jose G Venegas, Tilo Winkler, R Scott Harris
RATIONALE: Regional hypoventilation in bronchoconstricted asthmatics is spatially associated with reduced perfusion, which is proposed to result from Hypoxic Pulmonary Vasoconstriction (HPV). Our study aimed to determine the role of HPV in the regional perfusion redistribution in bronchoconstricted asthmatics. METHODS: Eight asthmatics completed PET-CT lung imaging at baseline and after bronchoconstriction, breathing either Room Air or 80% Oxygen (80%O2, separate days)...
June 23, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28633714/three-generation-family-with-congenital-central-hypoventilation-syndromeand-novel-phox2b-gene-non-polyalanine-repeat-mutation
#2
Ajay S Kasi, Taryn J Jurgensen, Stephanie Yen, Sheila S Kun, Thomas G Keens, Iris A Perez
PHOX2B non-polyalanine repeat mutation (NPARM) in patients with congenital central hypoventilation syndrome (CCHS) is generally considered to beassociated with full-time ventilator dependence and severe autonomic nervous system dysfunction. We report a three-generation family with four individualspossessing a novel PHOX2B NPARM (c.245C > T) with variable phenotypes. This mutation was inherited in an autosomal dominant pattern with variablepenetrance. The affected family members with CCHS have a milder phenotype than is typically expected with a NPARM...
June 16, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28632754/permissive-hypercapnia-for-severe-acute-respiratory-distress-syndrome-in-immunocompromised-children-a-single-center-experience
#3
Hans Fuchs, Nicola Rossmann, Manuel B Schmid, Manfred Hoenig, Ulrich Thome, Benjamin Mayer, Daniel Klotz, Helmut D Hummler
BACKGROUND: Controlled hypoventilation while accepting hypercapnia has been advocated to reduce ventilator-induced lung injury. The aim of the study was to analyze outcomes of a cohort of immunocompromised children with acute respiratory distress syndrome (ARDS) ventilated with a strategy of stepwise increasing PCO2 targets up to 140 mm Hg. METHODS: Retrospective analysis of outcomes of a cohort of children with oncologic disease or after stem cell transplantation and severe respiratory failure in comparison with a historical control cohort...
2017: PloS One
https://www.readbyqxmd.com/read/28625595/dctn1-related-neurodegeneration-perry-syndrome-and-beyond
#4
REVIEW
Takuya Konno, Owen A Ross, Hélio A G Teive, Jarosław Sławek, Dennis W Dickson, Zbigniew K Wszolek
Perry syndrome (PS) is a rare hereditary neurodegenerative disease characterized by autosomal dominant parkinsonism, psychiatric symptoms, weight loss, central hypoventilation, and distinct TDP-43 pathology. The mutated causative gene for PS is DCTN1, which encodes the dynactin subunit p150(Glued). Dynactin is a motor protein involved in axonal transport; the p150(Glued) subunit has a critical role in the overall function. Since the discovery of DCTN1 in PS, it has been increasingly recognized that DCTN1 mutations can exhibit more diverse phenotypes than previously thought...
June 12, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28622152/use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-emergent-surgical-tracheostomy-a-case-report
#5
Neel Desai, Anna Fowler
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...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28613919/hypercapnia-accelerates-adipogenesis-a-novel-role-of-high-co2-in-exacerbating-obesity
#6
Ryota Kikuchi, Takao Tsuji, Osamu Watanabe, Kazuhiro Yamaguchi, Kinya Furukawa, Hiroyuki Nakamura, Kazutetsu Aoshiba
Obesity is a major risk factor for the development of obstructive sleep apnea (OSA) and obesity hypoventilation syndrome (OHS), which manifest as intermittent hypercapnia and sustained plus intermittent hypercapnia, respectively. In this study, we investigated whether CO2 affects adipocyte differentiation (adipogenesis) and maturation (hypertrophy). Human visceral or subcutaneous preadipocytes were grown to confluence and then induced to differentiate to adipocytes under hypocapnia, normocapnia, and hypercapnia with or without hypoxia...
June 14, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28599619/a-devastating-case-of-diarrhea-associated-hemolytic-uremic-syndrome-associated-with-extensive-cerebral-infarction-why-we-need-to-do-better
#7
Werner Keenswijk, Evelyn Dhont, Ann Raes, An Bael, Johan Vande Walle
A 4-year-old girl with diarrhea-associated hemolytic uremic syndrome (D+HUS) was transferred to the PICU of our center due to deteriorating renal function and neurological involvement. On admission, a comatous child was seen with hypoventilation and she was placed on mechanical ventilation. Hemodialysis was commenced but plasma exchange was discontinued due to repeated hypersensitivity reactions. A trial of eculizumab was given in light of the worsening of her neurologic condition with development of a pyramidal syndrome and deepening of the coma...
June 9, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28574856/camera-based-measurement-of-respiratory-rates-is-reliable
#8
Christoph Becker, Stefan Achermann, Mukul Rocque, Ihor Kirenko, Andreas Schlack, Thomas Dreher-Hummel, Thomas Zumbrunn, Roland Bingisser, Christian H Nickel
OBJECTIVES: Respiratory rate (RR) is one of the most important vital signs used to detect whether a patient is in critical condition. It is part of many risk scores and its measurement is essential for triage of patients in emergency departments. It is often not recorded as measurement is cumbersome and time-consuming. We intended to evaluate the accuracy of camera-based measurements as an alternative measurement to the current practice of manual counting. MATERIALS AND METHODS: We monitored the RR of healthy male volunteers with a camera-based prototype application and simultaneously by manual counting and by capnography, which was considered the gold standard...
June 1, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28569555/sleep-and-mechanical-ventilation-in-stable-copd-patients
#9
Léo Grassion, Jésus Gonzalez-Bermejo
Respiratory work is physiologically increased during sleep and leads to severe alterations in COPD patients, especially by raising sleep hypoventilation. The diurnal impact of these nocturnal events may have been underestimated in COPD patients. Impaired sleep and the increase of respiratory work may be one of the major trigger of diurnal events like hypoventilation, exacerbation and even mortality. One of the most commonly used nocturnal treatments at the present time is noninvasive ventilation (NIV). However, there is an on-going debate concerning the indications and objectives of NIV in COPD patients...
June 1, 2017: COPD
https://www.readbyqxmd.com/read/28560615/effect-of-continuous-dialysis-on-blood-ph-in-acidemic-hypercapnic-animals-with-severe-acute-kidney-injury-a-randomized-experimental-study-comparing-high-vs-low-bicarbonate-affluent
#10
Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa, Marcelo Park
BACKGROUND: Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount importance in critical care settings. In this situation, the optimal concentration of sodium bicarbonate in the dialysate is still an unsolved question in critical care since high concentrations may worsen carbon dioxide levels and low concentrations may not be as effective in controlling pH...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28558398/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#11
Martin Gerlach, Bernd Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
May 30, 2017: Pneumologie
https://www.readbyqxmd.com/read/28533903/using-paco2-values-to-grade-obesity-hypoventilation-syndrome-severity-a-retrospective-study
#12
Mario Francesco Damiani, Vito Antonio Falcone, Pierluigi Carratù, Cristina Scoditti, Elioda Bega, Silvano Dragonieri, Alfredo Scoditti, Onofrio Resta
BACKGROUND: To date, an important aspect that has still not been clarified is the assessment of OHS severity. The purpose of this retrospective study was to evaluate whether grading OHS severity according to PaCO2 values may be useful in order to provide a more definite characterization and targeted management of patients. In this regard, baseline anthropometric and sleep polygraphic characteristics, treatment options, and follow up outcomes, were compared between OHS patients with different degree of severity (as assessed according to PaCO2 values)...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28524022/minimum-alveolar-concentration-and-cardiopulmonary-effects-of-isoflurane-in-ring-tailed-lemurs-lemur-catta
#13
Sathya K Chinnadurai, Julie A Balko, Cathy V Williams
The goal of this study was to determine the minimum alveolar concentration (MAC) and cardiopulmonary effects of isofluranein ring-tailed lemurs (Lemur catta). The MAC of isoflurane was determined by using a tail-clamp stimulus in adultring-tailed lemurs (6 male, 4 female). Once MAC was determined, another group of 10 adult ring-tailed lemurs (5 male, 5female) were anesthetized and instrumented similarly as the previous group and maintained at 0.5, 1, 1.5, and 2 times MACfor 15 min each with no external stimulation...
May 18, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#14
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#15
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#16
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28474099/a-three-step-diagnosis-of-pediatric-pneumonia-at-the-emergency-department-using-clinical-predictors-c-reactive-protein-and-pneumococcal-pcr
#17
Gabriel Alcoba, Kristina Keitel, Veronica Maspoli, Laurence Lacroix, Sergio Manzano, Mario Gehri, René Tabin, Alain Gervaix, Annick Galetto-Lacour
Recommendations for the management of community-acquired pneumonia (CAP) advocate that, in the absence of the clinical and laboratory findings typical of bacterial CAP, antibiotics are not required. However, the true value of the clinical and laboratory predictors of pediatric CAP still needs to be assessed. This prospective cohort study in three emergency departments enrolled 142 children with radiological pneumonia. Pneumonia with lung consolidation was the primary endpoint; complicated pneumonia (bacteremia, empyema, or pleural effusion) was the secondary endpoint...
May 4, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28466203/efficiency-of-oxygen-delivery-through-different-oxygen-entrainment-devices-during-sedation-under-low-oxygen-flow-rate-a-bench-study
#18
Wei-Chih Hsu, Joe Orr, Shih-Pin Lin, Lu Yu, Mei-Yung Tsou, Dwayne R Westenskow, Chien-Kun Ting
Sedative anesthetic procedures outside the operating room may depend on cylinders as oxygen source. Cylinders have limited storage capacity and a low oxygen flow rate improves the durability. We conducted the bench study to evaluate the fraction of inspired oxygen (FiO2) in different oxygen entrainment devices under low oxygen flow rate. The purpose of the bench study was to provide information to choose appropriate oxygen entrainment devices in non-operating room sedative anesthetic procedures. We utilized a manikin head-test lung-ventilator model and evaluated eight oxygen entrainment devices, including four nasal cannulas, two oral bite blocks, and two masks...
May 2, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28464566/multidetector-computed-tomographic-pulmonary-angiography-in-a-cat-with-fatal-heartworm-disease
#19
Ioannis Panopoulos, Swan Specchi, Nektarios Soubasis, Anastasia Papastefanou, Georgia Brellou, Edoardo Auriemma
A 17-month-old neutered male domestic shorthair cat was referred for a computed tomographic (CT) study of the thorax due to respiratory distress. Multidetector CT angiography showed a multifocal interstitial ground glass opacity, tortuous and blunted pulmonary arteries consistent with thromboembolism with perivascular lung infiltration and hypoventilation in multiple lung lobes. A blood antigen test was positive for Dirofilaria immitis. The cat's clinical condition rapidly declined and the owners elected euthanasia...
May 2, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28464318/examination-of-phox2b-in-adult-neuroendocrine-neoplasms-reveals-relatively-frequent-expression-in-pheochromocytomas-and-paragangliomas
#20
John P Lee, Yin P Hung, Thomas M O'Dorisio, James R Howe, Jason L Hornick, Andrew M Bellizzi
AIMS: Paired-like homeobox 2b (PHOX2B) is a transcription factor with expression outside of the central nervous system restricted to neurons and chromaffin cells of the autonomic nervous system. Germline mutations cause congenital central hypoventilation syndrome and predispose to neuroblastoma and Hirschsprung disease. Among pediatric small round cell tumors, PHOX2B is neuroblastoma-specific. Two studies of adult autonomic nervous system tumors (n=62) produced conflicting results (all tumors stained in one; expression was restricted to 40% of paragangliomas in the other)...
May 2, 2017: Histopathology
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