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https://www.readbyqxmd.com/read/28894372/frequent-respiratory-events-in-postoperative-patients-aged-60-years-and-above
#1
Suzanne Jl Broens, Xuan He, Rachel Evley, Erik Olofsen, Marieke Niesters, Ravi P Mahajan, Albert Dahan, Monique van Velzen
There is limited information on the occurrence of respiratory events in postoperative patients after discharge from the postanesthesia care unit. We studied the respiratory rate (RR) of 68 patients aged 60 years and above during the first 6 hours following elective surgery under general anesthesia to assess the frequency of respiratory events in the care unit and on the ward. RR was derived from the continuous RR counter RespiR8, measuring RR by quantifying the humidity of exhaled air. One-minute-averaged RRs were collected and analyzed to assess the frequency of postoperative bradypnea (RR 1-6 breaths/minute) and apnea (cessation of inspiratory flow ≥60 seconds)...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28879899/hyperekplexia-a-forgotten-diagnosis-clinched-by-next-generation-sequencing
#2
Meenakshi Lallar, Anukool Srivastava, Shubha R Phadke
Hyperekplexia is a rare early neonatal onset, potentially treatable, neurological disorder, characterized by a triad of immediate neonatal-onset stiffness, an exaggerated startle reflex in response to tactile or auditory stimuli followed by short periodical generalized stiffness. It is a monogenic genetically heterogeneous condition which can be potentially life threatening due to apneic episodes and is usually misdiagnosed as seizures. Here, we report two female siblings with hyperekplexia who were being treated by multiple antiepileptic medications for seizure-like episodes...
September 2017: Neurology India
https://www.readbyqxmd.com/read/28791755/emergency-department-use-of-apneic-oxygenation-versus-usual-care-during-rapid-sequence-intubation-a-randomized-controlled-trial-the-endao-trial
#3
Nicholas Caputo, Ben Azan, Rui Domingues, Lee Donner, Mark Fenig, Douglas Fields, Robert Fraser, Karlene Hosford, Richard Iuorio, Marc Kanter, Moira McCarty, Thomas Parry, Andaleeb Raja, Mary Ryan, Blaine Williams, Hemlata Sharma, Daniel Singer, Chris Shields, Sandra Scott, Jason R West
OBJECTIVES: Desaturation leading to hypoxemia may occur during rapid sequence intubation (RSI). Apneic oxygenation (AO) was developed to prevent the occurrence of oxygen desaturation during the apnea period. The purpose of this study was to determine if the application of AO increases the average lowest oxygen saturation during RSI when compared to usual care (UC) in the emergency setting. METHODS: A randomized controlled trial was conducted at an academic, urban, level 1 trauma center...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28775068/active-sleep-unmasks-apnea-and-delayed-arousal-in-infant-rat-pups-lacking-central-serotonin
#4
Jacob O Young, Aron M Geurts, Matthew Robert Hodges, Kevin J Cummings
Sudden Infant Death Syndrome (SIDS), occurring during sleep periods, is highly associated with abnormalities within serotonin (5-HT) neurons, including reduced 5-HT. There is evidence that future SIDS cases experience more apnea and have abnormal arousal from sleep. In rodents, a loss of 5-HT neurons is associated with apnea in early life and, in adulthood, delayed arousal. As the activity of 5-HT neurons changes with vigilance state, we hypothesized that the degree of apnea and delayed arousal displayed by rat pups specifically lacking central 5-HT varies with state...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28464406/sustained-apnea-induces-endothelial-activation
#5
Lars Eichhorn, Ramona Dolscheid-Pommerich, Felix Erdfelder, Muhammad Ajmal Ayub, Theresa Schmitz, Nikos Werner, Felix Jansen
BACKGROUND: Apnea diving has gained worldwide popularity, even though the pathophysiological consequences of this challenging sport on the human body are poorly investigated and understood. This study aims to assess the influence of sustained apnea in healthy volunteers on circulating microparticles (MPs) and microRNAs (miRs), which are established biomarkers reflecting vascular function. HYPOTHESIS: Short intermittent hypoxia due to voluntary breath-holding affects circulating levels of endothelial cell-derived MPs (EMPs) and endothelial cell-derived miRs...
September 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28460803/an-unexpected-presentation-of-sick-sinus-syndrome-isolated-ventricular-asystole
#6
Harun Gunes, Feruza Turan Sonmez, Halit Berk Canga, Ayhan Saritas
Sick sinus syndrome is a disorder of sinus node function characterized by various dysrhythmias such as sinus bradycardia or pause, paroxysmal regular or irregular atrial tachycardia, tachycardiabradycardia attacks or atrial fibrillation with slow ventricular response. Ventricular asystole with preserved atrial electrical activity is a rarely seen presenting rhythm in the ED and an extremely rare cause of syncope. A 67-year-old male having a syncope attack was admitted to the emergency department. His Glasgow coma scale score was 15 on admission...
August 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28412161/the-effect-of-the-apneic-period-on-the-respiratory-physiology-of-patients-undergoing-intubation-in-the-ed
#7
Jason R West, Anthony Scoccimarro, Cody Kramer, Nicholas D Caputo
OBJECTIVES: We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis. METHODS: This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Timed data collection forms were completed during the periintubation period...
September 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28325525/clinical-heterogeneity-of-glycine-encephalopathy-in-three-palestinian-siblings-a-novel-mutation-in-the-glycine-decarboxylase-gldc-gene
#8
Waseem Khraim, Bassam Abu-Libdeh, Suhail Ayesh, Imad Dweikat
INTRODUCTION: Glycine encephalopathy (GE), also known as non-ketotic hyperglycinemia (NKH), is a rare inborn error of glycine metabolism caused by a defect in glycine cleavage system, a multi-enzyme complex located in mitochondrial membrane. This defect results in elevated glycine concentration in plasma and cerebrospinal fluid (CSF). Clinical manifestations vary from severe lethargy, hypoactivity and apneic episodes in the neonatal form, mild or moderate psychomotor delay and seizures in the infantile form, and abnormal behaviors, ataxia and choreoathetoid movements in late onset form...
March 18, 2017: Brain & Development
https://www.readbyqxmd.com/read/28153424/seizure-associated-central-apnea-in-a-rat-model-evidence-for-resetting-the-respiratory-rhythm-and-activation-of-the-diving-reflex
#9
S M Villiere, K Nakase, R Kollmar, J Silverman, K Sundaram, M Stewart
Respiratory derangements, including irregular, tachypnic breathing and central or obstructive apnea can be consequences of seizure activity in epilepsy patients and animal models. Periods of seizure-associated central apnea, defined as periods >1s with rapid onset and offset of no airflow during plethysmography, suggest that seizures spread to brainstem respiratory regions to disrupt breathing. We sought to characterize seizure-associated central apneic episodes as an indicator of seizure impact on the respiratory rhythm in rats anesthetized with urethane and given parenteral kainic acid to induce recurring seizures...
May 2017: Neurobiology of Disease
https://www.readbyqxmd.com/read/28091857/lack-of-heart-rate-variability-during-sleep-related-apnea-in-patients-with-temporal-lobe-epilepsy-tle-an-indirect-marker-of-sudep
#10
C S Nayak, S Sinha, M Nagappa, K Thennarasu, A B Taly
PURPOSE: Apneas occurring during sleep may precipitate autonomic instability in epilepsy patients making them susceptible to sudden death (SUDEP). Literature on heart rate variability (HRV) during apnea among patients with temporal lobe epilepsy (TLE) is sparse. The aim of this study was to characterize the HRV during the peri-apneic period in patients with TLE and compare with HRV of matched healthy individuals during the overnight polysomnographic (PSG) recording. Further, the role of carbamazepine (CBZ) in modulating peri-apneic HRV in the above cohort was also assessed...
January 14, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27865065/how-do-we-recognize-the-child-with-osas
#11
REVIEW
Koen F Joosten, Helena Larramona, Silvia Miano, Dick Van Waardenburg, Athanasios G Kaditis, Nele Vandenbussche, Refika Ersu
Obstructive sleep-disordered breathing includes a spectrum of clinical entities with variable severity ranging from primary snoring to obstructive sleep apnea syndrome (OSAS). The clinical suspicion for OSAS is most often raised by parental report of specific symptoms and/or abnormalities identified by the physical examination which predispose to upper airway obstruction (e.g., adenotonsillar hypertrophy, obesity, craniofacial abnormalities, neuromuscular disorders). Symptoms and signs of OSAS are classified into those directly related to the intermittent pharyngeal airway obstruction (e...
February 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27843043/hyperekplexia-report-on-phenotype-and-genotype-of-16-jordanian-patients
#12
Amira Masri, Seo-Kyung Chung, Mark I Rees
BACKGROUND: Hyperekplexia, is a rare disorder characterized by excessive startle response to acoustic, visual, or other stimuli. It is inherited in autosomal recessive and dominant pattern. OBJECTIVE: To describe the clinical and genetic features of hyperekplexia in Jordanian patients. METHODS: This retrospective study includes all patients with proved genetic diagnosis of hyperekplexia who presented to our clinic at the Jordan University Hospital from January 2001 through July 2015...
April 2017: Brain & Development
https://www.readbyqxmd.com/read/27615064/prognostic-importance-of-novel-oxygen-desaturation-metrics-in-patients-with-heart-failure-and-central-sleep-apnea
#13
Eiichi Watanabe, Ken Kiyono, Shojiro Matsui, Virend K Somers, Kan Sano, Junichiro Hayano, Tomohide Ichikawa, Mayumi Kawai, Masahide Harada, Yukio Ozaki
BACKGROUND: Sleep-disordered breathing, particularly central sleep apnea (CSA), is highly prevalent in heart failure (HF) and an independent prognostic marker. We assessed the hypothesis that an increased hypoxemic burden during sleep may have greater prognostic value than the frequency of apneic and hypopneic episodes. METHODS AND RESULTS: We prospectively conducted overnight cardiorespiratory polygraphy on consecutive HF patients referred to our hospital from 2008 to 2011...
February 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/27590285/variants-in-slc18a3-vesicular-acetylcholine-transporter-cause-congenital-myasthenic-syndrome
#14
Gina L O'Grady, Corien Verschuuren, Michaela Yuen, Richard Webster, Manoj Menezes, Johanna M Fock, Natalie Pride, Heather A Best, Tatiana Benavides Damm, Christian Turner, Monkol Lek, Andrew G Engel, Kathryn N North, Nigel F Clarke, Daniel G MacArthur, Erik-Jan Kamsteeg, Sandra T Cooper
OBJECTIVE: To describe the clinical and genetic characteristics of presynaptic congenital myasthenic syndrome secondary to biallelic variants in SLC18A3. METHODS: Individuals from 2 families were identified with biallelic variants in SLC18A3, the gene encoding the vesicular acetylcholine transporter (VAChT), through whole-exome sequencing. RESULTS: The patients demonstrated features seen in presynaptic congenital myasthenic syndrome, including ptosis, ophthalmoplegia, fatigable weakness, apneic crises, and deterioration of symptoms in cold water for patient 1...
October 4, 2016: Neurology
https://www.readbyqxmd.com/read/27540704/neonatal-experiences-with-ethanol-intoxication-modify-respiratory-and-thermoregulatory-plasticity-and-affect-subsequent-ethanol-intake-in-rats
#15
María Belén Acevedo, Ana Fabiola Macchione, Florencia Anunziata, Olga Beatriz Haymal, Juan Carlos Molina
Different studies have focused on the deleterious consequences of binge-like or chronic exposure to ethanol during the brain growth spurt period (third human gestational trimester) that in the rat corresponds to postnatal days (PDs) 3-10. The present study analyzed behavioral and physiological disruptions caused by relatively brief binge-like exposures (PDs 3, 5, and 7) with an ethanol dose lower (3.0 g/kg) than those frequently employed to examine teratological effects during this stage in development. At PD 9, pups were exposed to ethanol doses ranging between ...
January 2017: Developmental Psychobiology
https://www.readbyqxmd.com/read/27485793/epileptic-phenotype-of-fgfr3-related-bilateral-medial-temporal-lobe-dysgenesis
#16
Tetsuya Okazaki, Yoshiaki Saito, Riyo Ueda, Takeya Awashima, Yoko Nishimura, Isao Yuasa, Yuki Shinohara, Kaori Adachi, Masayuki Sasaki, Eiji Nanba, Yoshihiro Maegaki
Hypochondroplasia (HCH) is a skeletal dysplasia, characterized by short stature and macrocephaly. Clinical symptoms and radiological and histopathological features of HCH are similar, but milder than those seen in achondroplasia. Particularly, HCH patients with Asn540Lys mutation in the FGFR3 gene are reported to have medial temporal lobe dysgenesis and epilepsy. We report a 3-year-old girl who developed recurrent epileptic apnea, which started immediately after birth. The apneic seizures were refractory to antiepileptic medications; ictal electroencephalography showed rhythmic activity originating from the left or right temporal areas and rarely from the right frontal area...
January 2017: Brain & Development
https://www.readbyqxmd.com/read/27468022/epinephrine-or-gv-26-electrical-stimulation-reduces-inhalant-anesthestic-recovery-time-in-common-snapping-turtles-chelydra-serpentina
#17
RANDOMIZED CONTROLLED TRIAL
Alexandra Goe, Justin Shmalberg, Bonnie Gatson, Pia Bartolini, Jeff Curtiss, James F X Wellehan
Prolonged anesthetic recovery times are a common clinical problem in reptiles following inhalant anesthesia. Diving reptiles have numerous adaptations that allow them to submerge and remain apneic for extended periods. An ability to shunt blood away from pulmonary circulation, possibly due to changes in adrenergic tone, may contribute to their unpredictable inhalant anesthetic recovery times. Therefore, the use of epinephrine could antagonize this response and reduce recovery time. GV-26, an acupuncture point with reported β-adrenergic and respiratory effects, has reduced anesthetic recovery times in other species...
June 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/27449231/apneic-events-a-proposed-new-target-for-respiratory-safety-pharmacology
#18
Dennis J Murphy
Current practice in respiratory safety pharmacology generally follows the regulatory guidance provided by the ICH document S7A and focuses on measures of pulmonary ventilation. What these measures do not account for is the ability of drugs to cause ventilatory instability or interruptions in ventilatory rhythm. Ventilatory instability can be identified by the presence of prolonged end-expiratory pauses or apneic periods. An apneic event has been defined as an apneic period of sufficient duration to cause hypoxia (i...
November 2016: Regulatory Toxicology and Pharmacology: RTP
https://www.readbyqxmd.com/read/27266401/incorporating-pharmacodynamic-considerations-into-caffeine-therapeutic-drug-monitoring-in-preterm-neonates
#19
Tian Yu, Alfred H Balch, Robert M Ward, E Kent Korgenski, Catherine M T Sherwin
BACKGROUND: This study sought to assess the pharmacokinetic and pharmacodynamic relationships of caffeine citrate therapy in preterm neonates who had therapeutic drug monitoring (TDM) in the post-extubation period. METHODS: A retrospective observational study was conducted in preterm neonates who received caffeine citrate therapy for apnea of prematurity and had TDM done in the post-extubation period between January 2006 and October 2011. The relationships between pharmacodynamic effects (heart rate, respiratory rate, episodes of apnea, adverse events) and caffeine serum concentrations were explored...
June 7, 2016: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27152499/hazards-of-intubation-in-the-icu-role-of-nasal-high-flow-oxygen-therapy-for-preoxygenation-and-apneic-oxygenation-to-prevent-desaturation
#20
Jean D Ricard
Acute respiratory failure is one the most common motives for intensive care unit admission. Although results from recent studies with high flow nasal oxygen have challenged our current management of these patients, a substantial number of them will require invasive mechanical ventilation and tracheal intubation. Life-threatening hypoxemia is the most frequent complication of these intubations. Desaturations occur despite properly conducted preoxygenation. Hence, alternatives are warranted to improve oxygenation during intubation...
October 2016: Minerva Anestesiologica
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