Document Detail

Diurnal hypercapnia in patients with neuromuscular disease.
MedLine Citation:
PMID:  20113985     Owner:  NLM     Status:  MEDLINE    
Subjects with progressive neuromuscular diseases undergo a typical sequence of respiratory compromise, leading from normal unassisted gas exchange to nocturnal hypoventilation with normal daytime gas exchange, and eventually to respiratory failure requiring continuous ventilatory support. Several different abnormalities in respiratory pump function have been described to explain the development of respiratory failure in subjects with neuromuscular weakness. Early in the progression of respiratory failure, the use of nocturnal assisted ventilation can reverse both night- and day-time hypercapnia. Eventually, however, diurnal hypercapnia will persist despite correction of nocturnal hypoventilation. The likely beneficial effects of mechanical ventilatory support include resting fatigue-prone respiratory muscles and resetting of the central chemoreceptors to PaCO(2). Recent experience shows that select patients who require daytime ventilation can be supported with non-invasive ventilation continuously to correct gas exchange abnormalities while avoiding detrimental aspects of tracheostomy placement.
Howard B Panitch
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Publication Detail:
Type:  Journal Article     Date:  2009-11-24
Journal Detail:
Title:  Paediatric respiratory reviews     Volume:  11     ISSN:  1526-0550     ISO Abbreviation:  Paediatr Respir Rev     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100898941     Medline TA:  Paediatr Respir Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  3-8     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Elsevier Ltd. All rights reserved.
The University of Pennsylvania School of Medicine, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
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MeSH Terms
Circadian Rhythm
Hypercapnia / etiology*,  therapy
Neuromuscular Diseases / complications*
Respiration, Artificial / methods
Respiratory Insufficiency / etiology,  therapy

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