| Urinary catecholamines before and after tracheostomy in patients with obstructive sleep apnea and hypertension. | |
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MedLine Citation:
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PMID: 3563246 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Obstructive apnea (asphyxia) is accompanied by acute elevation of systemic blood pressure. The usual nocturnal fall in blood pressure seen during sleep in normals may be absent in patients with repetitive apneas, and daytime systemic hypertension is reported to occur in up to 90% of such patients. Increased sympathetic activity in response to repetitive nocturnal episodes of asphyxia could explain the reversal of the diurnal pressure variation but not the daytime systemic hypertension in this setting. We examined diurnal variation in urinary catecholamines in eight subjects with severe apnea before and after tracheostomy. Five obese hypertensive subjects without apnea served as controls. Three urine specimens, two awake (7 a.m. to 3 p.m. and 3 p.m. to 11 p.m.) and one asleep (11 p.m. to 7 a.m.) were collected preoperatively and again 10-14 days postoperatively when the patient was free of pain and signs of stoma infection. All specimens were analyzed for epinephrine, norepineprine, metanephrine, and normetanephrine by liquid chromatography with electrochemical detection. Urinary epinephrine and metanephrine were not different between subjects and controls. Norepinephrine and normetanephrine were significantly higher in apneic subjects pretracheostomy as compared either with controls or with their own values posttracheostomy. Diurnal variation was not seen before or after tracheostomy. Only two of the controls showed significant diurnal variation in norepinephrine. We conclude that the absence of diurnal variation in catecholamines prior to tracheostomy reflects increased nocturnal sympathetic activity. Elevation of daytime norepinephrine and normetanephrine with return to control levels following tracheostomy implies increased sympathetic activity throughout the day. |
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Authors:
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E C Fletcher; J Miller; J W Schaaf; J G Fletcher |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Sleep Volume: 10 ISSN: 0161-8105 ISO Abbreviation: Sleep Publication Date: 1987 Feb |
Date Detail:
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Created Date: 1987-04-30 Completed Date: 1987-04-30 Revised Date: 2009-01-29 |
Medline Journal Info:
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Nlm Unique ID: 7809084 Medline TA: Sleep Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 35-44 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Catecholamines / urine* Circadian Rhythm Humans Hypertension / drug therapy, etiology, surgery, urine* Male Middle Aged Postoperative Period Sleep Apnea Syndromes / complications, surgery, urine* Tracheotomy* |
| Chemical | |
Reg. No./Substance:
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0/Catecholamines |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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