Document Detail


Cardio-respiratory Uncoupling in Congenital Central Hypoventilation Syndrome.
MedLine Citation:
PMID:  17281214     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Congenital Central Hypoventilation Syndrome (CCHS) is a rare disorder with failure of automatic control of breathing, defined by lack of an appropriate ventilatory response to hypercarbia and hypoxia. However, more detailed evaluation of cardiorespiratory coupling has not been previously performed in those with CCHS. We postulate that those with CCHS have disjointed cardiorespiratory responses to ventilatory challenges due to their alterations in sympathetic modulation. Therefore, we performed ventilatory rebreathing challenges with hypercarbia and hypoxia on 5 subjects with CCHS (age 21.2 &#177; 5.3 years; 3 females) and 7 controls (age 20.0 &#177; 4.0 years; 4 females). We measured breath-to-breath respiratory parameters (airflow, P<inf>ET</inf>co<inf>2</inf>, S<inf>a</inf>o<inf>2</inf>), ECG, and continuous non-invasive blood pressure. As previously shown, when compared to controls CCHS subjects lacked ventilatory responses to isocapnic hypoxia (p=0.004) and hyperoxic hypercarbia (p=0.002). During hypercapnia, both control and CCHS subjects had similar rates of decrease in R-R intervals (RRI; slope -1.3 &#177; 2.5 vs. -1.4 &#177; 1.1, n.s.) and increase in beat-to-beat averaged blood pressure (MBP; slope 1.2 &#177; 0.3 vs. 0.4 &#177; 0.1, n.s.) as P<inf>ET</inf>co<inf>2</inf>increased. During hypoxia, both control and CCHS groups had similar rates of decrease in RRI (slope 14.2 &#177; 3.0 vs. 7.5 &#177; 3.9, n.s.) and increase in MBP (slope -1.11 &#177; 1.12 vs. -0.9 &#177; 0.8, n.s.) as S<inf>a</inf>o<inf>2</inf>decreased. We conclude that despite having a markedly diminished ventilatory response to hypercarbia and hypoxia, subjects with CCHS have normal cardiovascular responses to these challenges. We speculate that this indicates that chemoreceptors are functional.
Authors:
Maida Lynn Chen; S L Davidson Ward; Thomas Keens; Zheng Lin; Michael K Khoo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference     Volume:  4     ISSN:  1557-170X     ISO Abbreviation:  Conf Proc IEEE Eng Med Biol Soc     Publication Date:  2005  
Date Detail:
Created Date:  2007-02-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101243413     Medline TA:  Conf Proc IEEE Eng Med Biol Soc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4412-5     Citation Subset:  -    
Affiliation:
Childrens Hospital Los Angeles, Division of Pediatric Pulmonology, Keck School of Medicine, University of Southern California, Los Angeles, California.
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