Treatment Effects on Carbon Dioxide Retention in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome
This study was designed to examine respiratory control in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), with or without CO2 retention. We recruited 10 body mass index-matched, apnea-hypopnea index-matched, age-matched, and lung function-matched OSAHS patients, according to their a...
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Published in | Chest Vol. 119; no. 6; pp. 1814 - 1819 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
Northbrook, IL
Elsevier Inc
01.06.2001
American College of Chest Physicians |
Subjects | |
Online Access | Get full text |
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Summary: | This study was designed to examine respiratory control in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), with or without CO2 retention.
We recruited 10 body mass index-matched, apnea-hypopnea index-matched, age-matched, and lung function-matched OSAHS patients, according to their awake Paco2. Five patients were hypercapnic (Paco2, ≥ 45 mm Hg), and five patients were eucapnic. Hypoxic responses (the ratio of the change in minute ventilation [Δ V˙e] to the change in arterial oxygen saturation[ΔSao2] and the ratio of the change in mouth occlusion pressure over the first 100 ms of inspiration against an occluded airway [ΔP0.1] to Δ Sao2) and hypercapnic responses (Δ V˙e/ΔPco2 ratio andΔP0.1/ΔPco2 ratio) were testedduring wakefulness before treatment in all 10 patients, and before and during treatment (at 2, 4, and 6 weeks) with pressure support in the hypercapnic group.
Hypercapnic patients had lower mean (± SD)Δ V˙e/Δ Sao2 ratio than eucapnic patients (−0.17 ± 0.04 vs −0.34 ± 0.04 L /min/% Sao2, respectively), lower meanΔP0.1/Δ Sao2 ratio(−0.04 ± 0.02 vs −0.14 ± 0.03 cm H2O/% Sao2, respectively), and lower ΔP0.1/ΔPco2 ratio(0.23 ± 0.1 vs 0.49 ± 0.1 cm H2O/mm Hg, respectively)[p < 0.05]. After receiving noninvasive ventilation treatment, the hypercapnic and hypoxic responses of the hypercapnic patients increased. At 4 to 6 weeks, values for both responses had increased to within the normal range and Paco2 had fallen to< 45 mm Hg, while weight was unchanged.
Depressed chemoresponsiveness plays a role that is independent of obesity in the development of CO2 retention in some OSAHS patients, and it may be a response to sleep-disordered breathing. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0012-3692 1931-3543 |
DOI: | 10.1378/chest.119.6.1814 |