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At least 19 recordsLinked to original sources
PubMed1992

A comparison of sleep-disordered respiration in ESRD patients receiving hemodialysis and peritoneal dialysis.

STUDY OBJECTIVE: To compare sleep-disordered respiration in ESRD patients receiving peritoneal dialysis and hemodialysis. DESIGN: Subjective and objective measures of sleep were recorded in two groups of ESRD patients receiving PD and HD. SETTING: Tertiary-referral university hospital PATIENTS AND METHODS: Fifteen PD patients (12 males, 3 females) and 15 HD patients (11 males, 4 females) were studied for two nights in the sleep laboratory. RESULTS: Ten of the 15 PD patients and 8 of the 15 HD patients reported multiple types of sleep difficulties (NS). In the PD group, seven described substantial difficulty initially going to sleep; ten were troubled by awakenings during the night, while seven suffered from daytime sleepiness. In the HD group, seven described substantial difficulty initially going to sleep; eight were troubled by awakenings during the night, while five experienced day-time sleepiness. No significant difference was observed in total sleep time, intermittent wake time, sleep latency, sleep efficiency, total disordered breathing events, minimum oxygen saturation and periodic leg movements between the PD and HD groups. Sleep apnea was noted in 9 of 15 PD and 8 of 15 HD patients. CONCLUSIONS: This study indicates that the incidence and severity of sleep apnea is similar in ESRD patients receiving chronic peritoneal dialysis and hemodialysis.

Female↗
PubMed1979

[Respiration disorders after severe mechanical trauma].

The external respiration has been studied in 221 patients. The disorders in pulmonary gas exchange subsequent to an injury are due to decreased ventilation volumes, delayed diffusion of inhaled gases and disturbed blood circulation in the lungs. Functional disorders are often aggravated by pulmonary complications.

Adult↗
PubMed1992

[Obstructive respiration disorders. An aneurysm of the ventilator tubing during general anesthesia].

Technical problems during anaesthesia are important causes of anaesthesia-related deaths and brain damage. During general endotracheal anaesthesia for ophthalmic surgery (41-year-old man, ASA 1) we observed an increase in inspiratory pressure without other clinical changes. Disconnection and ventilation with a resuscitation bag showed normal inspiratory pressures. Inspection demonstrated an obstruction due to an aneurysm of the inner layer of the inspiratory tubing. The classification of this rare blockage of ventilation differs in the literature (pressure, hypoventilation, hypercarbia). In addition, it demonstrates the principal problem of clinical decision-making during anaesthesia based on monitoring information. Strategies for responding to alarms indicating hazards of ventilation must be based on immediate restoration of sufficient ventilation, and not primarily on detecting the cause.

Adult↗
PubMed1977

[Evaluation of the external respiratory and lesser circulatory function in acute postinfarct cardiac aneurysm].

The function of pulmonary respiration was studied in 28 patients with acute postinfarction aneurysms of the heart, in 20 normal individuals and in 25 patients with transmural myocardial infarction non-complicated by by cardiac aneurysm. A comparative analysis of the obtained data has shown that patients with acute postinfarction aneurysms of the heart have more severe pulmonary respiration disorders than those with transmural myocardial infarctions. The degree of these disorders grows in accordance with the degree of circulation insufficiency. The authors believe the main cause of such pulmonary respiration disorders in cardiac aneurysms to consist in a reduced contractile capacity of the heart muscle with subsequent disturbances in the intracardiac haemodynamics and the development of pulmonary hypertension. The authors recommend to take into account the degree of pulmonary respiration disorders when determining the vital and occupational prognosis, as well as the indications for a surgical management of this complication of myocardial infarction.

Acute Disease↗
PubMed1992

Blockade of NMDA receptor-channels by MK-801 alters breathing in adult rats.

The role of N-methyl-D-aspartate (NMDA) receptor-channel activation in the production of respiratory pattern was studied by administration of the NMDA receptor-channel blocker (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine hydrogen maleate (MK-801, 1-3 mg/kg, i.v.) to anesthetized adult rats. This dose of MK-801 blocked the excitatory effects of NMDA (applied iontophoretically) on brainstem respiratory neurons. The predominant respiratory response to systemic MK-801 administration was an increase in inspiratory duration and a decrease in amplitude of diaphragm electromyogram and phrenic nerve discharge. Effects on inspiratory timing and amplitude were most pronounced when the rats were vagotomized. Significant changes in arterial blood gases and pH after systemic MK-801 administration in spontaneously breathing rats (vagi intact or cut) indicated that ventilation was depressed by NMDA receptor-channel antagonism. Respiratory timing changes in response to systemic MK-801 administration differed between two rat strains studied. Breathing patterns resembling apneusis, i.e., with irregular inspiratory durations prolonged 2- to 30-fold, occurred in 60% of the vagotomized, spontaneously breathing Sprague-Dawley rats and none of the Wistar rats. Thus, the breathing pattern in Sprague-Dawley rats is more sensitive to interference with NMDA-mediated mechanisms. We propose that respiratory pattern generation and transmission of rhythmic respiratory drive are mediated by synergistic activation of NMDA and non-NMDA receptors at brainstem and spinal cord sites.

Anesthesia↗
PubMedDate not supplied

[Assisted ventilation of newborn infants during sleep. Study of factors modifying adaptation to ventilation].

During sleep, of ventilated newborns and young infants, spontaneous respiratory movements may occur, unrelated to the ventilation impulsions. The respiratory pattern is then classified as "active". On the contrary, the respiratory pattern is classified as "passive", when all respiratory movements are related to the ventilation insufflation. The factors which influence the dependence on the ventilator are studied in a group of 20 newborn and young infants. Prematurity, some biological data such as hyperoxia, hypocapnia, seem to favor this dependence. A rapid rate of ventilation (superior to 30/minute) is rarely related to an active respiration; a slow rate of ventilation seems favor this respiratory pattern. It is clear that adaptation to artificial ventilation is better during quiet sleep than during active sleep. Some physiopathological considerations are developed.

Adaptation, Physiological↗
PubMed1978

Vocal cord closure. A cause of upper airway obstruction during controlled ventilation.

Studies of vocal cord function were undertaken in a quadriplegic patient requiring ventilatory assistance, and in 2 normal subjects during controlled ventilation in a tank-type respirator. When the patient and the normal subjects relaxed and made no conscious effort to assist the respirator, the vocal cords were observed to close during inspiration and a large pressure gradient (12 to 19 cm H2O) developed across the cords. When the subjects made a slight inspiratory effort ("assist" mode), the cords opened widely during inspiration. There were large increases in flow and tidal volume in the "assist" mode compared with passive ventilation. Measurements of transdiaphragmatic pressure and esophageal pressure showed that these variables did not increase with the slight assist. Thus, increase in ventilation during the "assist" mode appeared to be due to alleviation of inspiratory obstruction at the level of the vocal cords. The same phenomenon was observed in the patient during phrenic nerve pacing. A pacemaker was designed to be triggered by the electromyographic impulse from an accessory muscle of respiration. In this manner, vocal cord opening could be coordinated with the mechanical assist given by the phrenic nerve pacer.

Adult↗
PubMed1979

Ventilation-perfusion imbalance after head trauma.

To investigate the role of ventilation-perfusion (VA/Q) imbalance in the hypoxemia observed after head injury, 5 male subjects (17 to 26 years of age) with isolated head trauma and subsequent hypoxemia were studied. Disturbances of ventilation and perfusion were assessed using the steady-state elimination of six inert gases of different solubilities. Paired studies were conducted during mechanical ventilation with a volume-cycled ventilator and during spontaneous ventilation. Distributions recovered from studies of spontaneous ventilation show a mode of ventilation and perfusion near a VA/Q of 1.0. In addition, 41% of the cardiac output was distributed to a second population of lung units with low VA/Q (less than 0.1) and shunt. During mechanical ventilation, perfusion to these regions of low VA/Q decreased to 21% of the cardiac output, whereas shunt fraction was unchanged. This was associated with a marked broadening of the VA/Q mode near 1.0, relative to the studies during spontaneous ventilation. Mean functional residual capacity during mechanical ventilation was not different from that during spontaneous ventilation. These results suggest that head injury can lead to hypoxemia through a failure of VA/Q regulatory mechanisms.

Adolescent↗
PubMed1992

Ventilatory dysfunction in severe anorexia nervosa.

A 25-year-old woman suffering from chronic anorexia nervosa lost more than 50 percent of her body weight and presented with generalized muscle weakness. Pulmonary function tests showed a severe restrictive defect, and she had marked impairment of respiratory muscle strength and endurance, peripheral muscle function, and hypercapnic ventilatory responses, all of which improved following refeeding. The interaction and response to treatment of these effects on respiratory function are discussed.

Adult↗