Document Detail

Effects of inhaled carbon dioxide and oxygen on cheyne-stokes respiration in patients with heart failure.
MedLine Citation:
PMID:  10228116     Owner:  NLM     Status:  MEDLINE    
We hypothesized that in patients with congestive heart failure (CHF), reductions in PaCO2 sensed at the peripheral chemoreceptors trigger central apneas during Cheyne-Stokes respiration (CSR-CSA), and that raising PaCO2 by inhalation of a CO2 would eliminate these events. The effects of CO2 inhalation on the frequency of apneas and hypopneas during stage 2 (S2) sleep were studied in 10 CHF patients with CSR-CSA. The time from the breath with the minimal end tidal fraction of CO2 (FETCO2) during hyperpnea until the onset of apnea correlated strongly with the lung to ear circulation time (LECT) (r2 = 0.90, p < 0.0001), a measure of lung to carotid body circulatory delay. Among the six patients who also inhaled O2, CO2 inhalation increased transcutaneous PCO2 (PtcCO2) (36.4 +/- 4.6 mm Hg versus 38 +/- 4.4 mm Hg, p < 0.002), abolished central apneas and hypopneas (43.0 +/- 8.4 per hour on air versus 1.6 +/- 2.6 per hour on CO2, p < 0.0001), and increased SaO2. In contrast, O2 inhalation causing a similar rise in SaO2 had no significant impact on either PtcCO2 or the frequency of central events. We conclude that central apneas in patients with CHF are triggered by a low PaCO2 most likely sensed at the peripheral chemoreceptors, and that inhalation of CO2 reverses central apneas by raising PaCO2.
G Lorenzi-Filho; F Rankin; I Bies; T Douglas Bradley
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  159     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-14     Completed Date:  1999-06-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1490-8     Citation Subset:  AIM; IM    
Sleep Research Laboratory of the Mount Sinai Hospital, and Department of Medicine, The Toronto Hospital, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Administration, Inhalation
Apnea / epidemiology,  etiology,  physiopathology
Carbon Dioxide / blood,  pharmacology*
Cheyne-Stokes Respiration / blood,  physiopathology*
Heart Failure / complications,  physiopathology*
Middle Aged
Oxygen / pharmacology*
Partial Pressure
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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