| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
Chest, Vol 89, 627-635, Copyright © 1986 by American College of Chest Physicians
ARTICLES |
DM Rapoport, SM Garay, H Epstein and RM Goldring
The mechanisms of hypercapnia in eight patients with the "Pickwickian" syndrome and obstructive sleep apnea (OSAS) were evaluated pretherapy and posttherapy (tracheostomy in seven patients and chronic nocturnal use of nasal CPAP in one). Four patients (correctors) became eucapnic within two weeks of therapy. Four others (noncorrectors) remained hypercapnic. Neither residual apneas, changes in pulmonary function, change in anatomic dead space, nor changes in ventilatory chemoresponsiveness differentiated the two groups, nor did the last three factors account for return to eucapnia in the correctors. The results indicated two separate mechanisms exist for chronic hypercapnia in OSAS: a critical balance between the ventilation during the time spent awake and hypoventilation due to apneas, a mechanism removed by treatment for obstructive apnea; and sustained hypoventilation independent of the apnea phenomenon and therefore not correctible. The subset of patients with the second mechanism appears to represent the true "Pickwickian" syndrome and can be identified before therapy by measuring a low level of ventilation in the sustained awake state.
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]
|
|
|
|
 |
|
 R. G. Norman, R. M. Goldring, J. M. Clain, B. W. Oppenheimer, A. N. Charney, D. M. Rapoport, and K. I. Berger Transition from acute to chronic hypercapnia in patients with periodic breathing: predictions from a computer model J Appl Physiol, May 1, 2006; 100(5): 1733 - 1741. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Deane and A Thomson Obesity and the pulmonologist Arch. Dis. Child., February 1, 2006; 91(2): 188 - 191. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. P. de Llano, R. Golpe, M. O. Piquer, A. V. Racamonde, M. V. Caruncho, O. C. Muinelos, and C. A. Carro Short-term and Long-term Effects of Nasal Intermittent Positive Pressure Ventilation in Patients With Obesity-Hypoventilation Syndrome Chest, August 1, 2005; 128(2): 587 - 594. [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]
|
|
|
|
|
|
K. I. Berger, I. Ayappa, I. B. Sorkin, R. G. Norman, D. M. Rapoport, and R. M. Goldring Postevent ventilation as a function of CO2 load during respiratory events in obstructive sleep apnea J Appl Physiol, September 1, 2002; 93(3): 917 - 924. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Gozal Determinants of Daytime Hypercapnia in Obstructive Sleep Apnea : Is Obesity the Only One To Blame? Chest, February 1, 2002; 121(2): 320 - 321. [Full Text] [PDF]
|
|
|
|
|
|
T. Akashiba, S. Kawahara, N. Kosaka, D. Ito, O. Saito, T. Majima, and T. Horie Determinants of Chronic Hypercapnia in Japanese Men With Obstructive Sleep Apnea Syndrome Chest, February 1, 2002; 121(2): 415 - 421. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. I. Berger, I. Ayappa, B. Chatr-amontri, A. Marfatia, I. B. Sorkin, D. M. Rapoport, and R. M. Goldring Obesity Hypoventilation Syndrome as a Spectrum of Respiratory Disturbances During Sleep Chest, October 1, 2001; 120(4): 1231 - 1238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Teichtahl The Obesity-Hypoventilation Syndrome Revisited Chest, August 1, 2001; 120(2): 336 - 339. [Full Text] [PDF]
|
|
|
|
|
|
R. Kessler, A. Chaouat, P. Schinkewitch, M. Faller, S. Casel, J. Krieger, and E. Weitzenblum The Obesity-Hypoventilation Syndrome Revisited : A Prospective Study of 34 Consecutive Cases Chest, August 1, 2001; 120(2): 369 - 376. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Han, E. Chen, H. Wei, Q. He, D. Ding, and K. P. Strohl Treatment Effects on Carbon Dioxide Retention in Patients With Obstructive Sleep Apnea-Hypopnea Syndrome Chest, June 1, 2001; 119(6): 1814 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Jokic, T Zintel, G Sridhar, C G Gallagher, and M F Fitzpatrick Ventilatory responses to hypercapnia and hypoxia in relatives of patients with the obesity hypoventilation syndrome Thorax, November 1, 2000; 55(11): 940 - 945. [Abstract] [Full Text]
|
|
|
|
|
|
D. D. Sin, R. L. Jones, and G. C. Man Hypercapnic Ventilatory Response in Patients With and Without Obstructive Sleep Apnea: Do Age, Gender, Obesity, and Daytime PaCO2 Matter? Chest, February 1, 2000; 117(2): 454 - 459. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. I. Berger, I. Ayappa, I. B. Sorkin, R. G. Norman, D. M. Rapoport, and R. M. Goldring CO2 homeostasis during periodic breathing in obstructive sleep apnea J Appl Physiol, January 1, 2000; 88(1): 257 - 264. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Kim, D. W. Eisele, P. L. Smith, H. Schneider, and A. R. Schwartz Evaluation of Patients With Sleep Apnea After Tracheotomy Arch Otolaryngol Head Neck Surg, September 1, 1998; 124(9): 996 - 1000. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
