HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Han, F. Articles by Strohl, K. P. Search for Related Content PubMed PubMed Citation Articles by Han, F. Articles by Strohl, K. P.

Treatment Effects on Carbon Dioxide Retention in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome^*

^* From the Department of Medicine (Drs. Han and Strohl), Louis Stokes VA Medical Center, Case Western Reserve University, Cleveland, OH; and the Department of Medicine (Drs. Chen, He, and Ding, and Ms. Wei), People’s Hospital, Medical School of Beijing University, Beijing, China.

Correspondence to: Kingman P. Strohl, MD, FCCP, VAMC 111j(w), 10701 East Blvd, Cleveland OH 44106; e-mail: KPSTROHL{at}aol.com

Objectives: This study was designed to examine respiratory control in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), with or without CO₂ retention.

Methods: We recruited 10 body mass index-matched, apnea-hypopnea index-matched, age-matched, and lung function-matched OSAHS patients, according to their awake PaCO₂. Five patients were hypercapnic (PaCO₂, 45 mm Hg), and five patients were eucapnic. Hypoxic responses (the ratio of the change in minute ventilation [E] to the change in arterial oxygen saturation [SaO₂] and the ratio of the change in mouth occlusion pressure over the first 100 ms of inspiration against an occluded airway [P_0.1] to SaO₂) and hypercapnic responses (E/PCO₂ ratio and P_0.1/PCO₂ ratio) were tested during wakefulness before treatment in all 10 patients, and before and during treatment (at 2, 4, and 6 weeks) with pressure support in the hypercapnic group.

Results: Hypercapnic patients had lower mean (± SD) E/SaO₂ ratio than eucapnic patients (-0.17 ± 0.04 vs -0.34 ± 0.04 L /min/%SaO₂, respectively), lower mean P_0.1/SaO₂ ratio (-0.04 ± 0.02 vs -0.14 ± 0.03 cm H₂O/%SaO₂, respectively), and lower P_0.1/PCO₂ ratio (0.23 ± 0.1 vs 0.49 ± 0.1 cm H₂O/mm Hg, respectively) [p < 0.05]. After receiving noninvasive ventilation treatment, the hypercapnic and hypoxic responses of the hypercapnic patients increased. At 4 to 6 weeks, values for both responses had increased to within the normal range and PaCO₂ had fallen to < 45 mm Hg, while weight was unchanged.

Conclusions: Depressed chemoresponsiveness plays a role that is independent of obesity in the development of CO₂ retention in some OSAHS patients, and it may be a response to sleep-disordered breathing.

Key Words: CO₂ retention • obstructive sleep apnea-hypopnea syndrome • respiratory control

This article has been cited by other articles:

				N. Kawata, K. Tatsumi, J. Terada, Y. Tada, N. Tanabe, Y. Takiguchi, and T. Kuriyama Daytime Hypercapnia in Obstructive Sleep Apnea Syndrome Chest, December 1, 2007; 132(6): 1832 - 1838. [Abstract] [Full Text] [PDF]

				B. Mokhlesi and A. Tulaimat Recent Advances in Obesity Hypoventilation Syndrome Chest, October 1, 2007; 132(4): 1322 - 1336. [Abstract] [Full Text] [PDF]

				J.-P. Laaban, E. Chailleux, and for the Observatory Group of ANTADIR Daytime Hypercapnia in Adult Patients With Obstructive Sleep Apnea Syndrome in France, Before Initiating Nocturnal Nasal Continuous Positive Airway Pressure Therapy Chest, March 1, 2005; 127(3): 710 - 715. [Abstract] [Full Text] [PDF]

				I. Ayappa, K. I. Berger, R. G. Norman, B. W. Oppenheimer, D. M. Rapoport, and R. M. Goldring Hypercapnia and Ventilatory Periodicity in Obstructive Sleep Apnea Syndrome Am. J. Respir. Crit. Care Med., October 15, 2002; 166(8): 1112 - 1115. [Abstract] [Full Text] [PDF]