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Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 61 patients with chronic cor pulmonale with compensation and decompensation of circulation, the stroke and minute heart volume were studied as well as the indices, characterizing the blood-gas contents and acid-base blood state. The minute heart volume in the patients examined proved to be with normal values. Stroke heart volume is decreased in all patients examined with chronic cor pulmonale. The acceleration of heart activity enables the maintenance of normal minute volume. Hypoxemia has a cardiac depressive effect as regards minute volume and heart rate. The moderate hypercapnia has a certain stimulating effect on heart. A direct proportional correlation exists between the hypercapnia degree and the tendency of minute volume increase and especially of heart rate. The campaign against hypoxemia is an essential element in the prophylaxis and early treatment of chronic cor pulmonale.
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PMID:[Cardiac output, blood gas analysis and the acid-base state of the blood in chronic cor pulmonale]. 1 45

Left ventricular function was studied at rest and during post-extrasystolic potentiation in 18 patients with chronic obstructive lung disease. The contractility indices used were obtained from pressures recorded in the isovolumetric period (left ventricular end-diastolic pressure, Vmax., VECmax., dP/dtmax.) and from volume variations during ejection (end-diastolic volume, ejection fraction, VCF). Left ventricular diastolic compliance was also evaluated. All patients were hypoxic (PaO2 = 58 +/- 7 torr); six of them had cor pulmonale (group B); the remaining 12 patients constituted group A. Left ventricular function of groups A and B was similar; we conclude that right cardiac failure, in cor pulmonale, is not secondary to left ventricular failure. However, left ventricular dysfunction exists; the left ventricle is hypertrophied (probably resulting from chronic hypoxia). Pump function is altered (abnormal ventricular function points are found), but left ventricular kinetics is normal or exaggerated (ejection fraction and VCF are increased). Isovolumetric phase contractility indices are diminished; however, they may increase normally during post-extrasystolic potentiation. Left ventricular compliance is abnormal due to left and right ventricular hypertrophy and to paradoxical movement of the interventricular septum which impedes diastolic expansion of the left ventricle. These changes are responsible for decreased left ventricular output. There seems to exist an impairment of left ventricular function related to both intrinsic (secondary to hypoxia, hypercapnia, left ventricular hypertrophy) and extrinsic factors (right ventricula hypertrophy deviating interventricular septum, lowering of left ventricular preload).
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PMID:[Left ventricular function in chronic obstructive lung disease (author's transl)]. 15 43

A case of primary alveolar hypoventilation is described. Despite characteristic clinical findings, the diagnosis was delayed for 4 years. Alleviation of nocturnal hypoxemia and hypercapnia initially by a rocking bed and subsequently by phrenic nerve stimulation was accompanied by reversal of cor pulmonale and polycythemia. Electrophrenic respiration is an effective form of long-term management in primary alveolar hypoventilation.
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PMID:Primary alveolar hypoventilation treated with nocturnal electrophrenic respiration. 30 26

Two uses of intermittent positive pressure can be distinguished: one supports inhalotherapy and the other longterm assisted ventilation. The apparatus can be connected to the patient either through mouth-piece or by tracheostomy. The main factors involved in the indication of assisted ventilation are the number of acute failures, hypoxemia, hypercapnia, cor pulmonale. In our department, 53 patients were kept under prolonged supervision before a decision was made to use assisted ventilation or not. This attitude seems absolutely necessary. An oxygen test of several hours provides very useful information. Finally, the authors review the indication of various ventilation methods (tracheostomy, oral) in relation to different chronic respiratory insufficiency etiologies (ie., chronic obstructive broncho-pneumonia, restrictive syndrome).
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PMID:[Preliminary report and indications of assisted ventilation at home (author's transl)]. 39 49

A case of cor pulmonale is reported, due to chronic nasopharyngeal obstruction by hypertrophied tonsils and adenoids. This syndrome is characterized by stridor, somnolence, arterial hypoxia and hypercarbia, pulmonary and right heart failure. The pathogenesis of this syndrome is due to pulmonary hypoventilation. After tonsillectomy and adenoidectomy the symptoms disappeared.
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PMID:[Cor pulmonale due to upper airway obstruction by hypertrophied tonsils and adenoids (author's transl)]. 74 83

Seventeen male patients with chronic obstructive airways disease in remission were separated into two groups according to arterial carbon dioxide tensions. Hypercapnia was associated significantly with hypoxia and increased red cell volume whereas normocapnia was not. Normocapnic patients were significantly lighter than those with hypercapnia. Total body potassium (TBK) measured by the whole body monitor was significantly low in two of the patients studied (P less than 0.005). The mean value for TBK for the normocapnic group as a whole was significantly low (P less than 0.005), but the mean value for the hypercapnic group was not. Serum potassium and erythrocyte potassium concentrations were normal even when TBK was low, and diuretics had no apparent influence on these potassium values. Of four patients (two in the series and two others) who had TBK measured after a recent episode of cor pulmonale, three had significantly low values. The only previous studies using a whole body monitor to measure TBK in chronic obstructive airways disease found no such low values, though other workers estimating exchangeable potassium by isotope dilution techniques had found evidence of gross potassium depletion. It is concluded that low TBK does indeed occur in patients with chronic obstructive airways disease and that gross depletion is more likely to follow an episode of cor pulmonale.
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PMID:Potassium studies in chronic obstructive airways disease. 74 98

Chronic hypertrophied tonsils and adenoids causing partial airway obstruction produced serious illness and a confusing clinical picture in a 51/2-year-old boy. Cardinal signs were cor pulmonale, pulmonary oedema and marked cardio-respiratory changes due to hypoxaemia and hypercapnia, in addition to hypersomnia. Marked improvement of the clinical picture and the abnormal signs followed directly upon tonsillectomy and adenoidectomy. Chronic alveolar hypoventilation is presumably the main cause of the described condition and of others of extracardiac origin with similar signs and symptoms.
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PMID:[Chronic tonsillar hypertrophy as a cause of cor pulmonale, pulmonary oedema, and hypersomnia in children (author's transl)]. 89 99

For over 15 years, upper respiratory tract obstruction due to adenotonsillar hypertrophy has been known to cause hypoxia, hypercapnia, increased pulmonary vascular resistance and thereby cor pulmonale and congestive heart failure. This is now an uncommon but not rare entity and three recent cases prompted this report. The typical patient is dyspneic with retractions, cyanosis, occasional periods of apnea and somnolence. Edema and hepatomegaly and at times splenomegaly are common. X-rays show cardiomegaly, which on electrocardiogram is found to involved mainly the right ventricle. The strict definition of cor pulmonale is right ventricular hypertrophy secondary to lung disease or abnormal pulmonary function, a definition that may logically be stretched to include abnormal respiratory function secondary to upper airway pathology. The mechanisms by which this occurs are generally agreed upon. Hypoxia has been demonstrated to cause pulmonary vasoconstriction. Acidosis and hypercapnia are thought by some to have the same effect. Pressure across the pulmonary vascular bed is also increased, as predicted by Poiseuille's law, by the high rate of blood flow required to maintain tissue oxygenation with poorly oxygenated blood. Conditions producing hypoxia of hypercapnia or both lead to hypertrophy and eventually to dilatation of the right ventricle. Three cases of children who underwent cardiac catheterization while suffering from cor pulmonale due to adenotonsillar hypertrophy are reported. Right ventricular pressure averaged 44/5, PAO2 72, pH 7.32, and PACO2 52. All were clinically improved following adenotonsillectomy. Cardiac catheterization was repeated in one case, with right ventricular pressure dropping from 44/5 to 21/2, pulmonary vascular resistance from eight units to three, and PACO2 from 62 to 44.
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PMID:Cardiac and pulmonary failure secondary to adenotonsillar hypertrophy. 95 48

Ten patients with the Pickwickian syndrome, characterized by obesity, hypoxemia, hypercapnia, polycythemia, and cor pulmonale, underwent long-term treatment as outpatients with medroxyprogesterone acetate. Although there was no significant weight change in the group, PaO2 rose 12.6 +/- 2.7 mm Hg (SEM) from 49 +/- 2.6 mm Hg to 62 +/- 2.3 mm Hg (P less than 0.001), while PaCO2 fell 13 +/- 2.6 mm Hg from 51 +/- 1.9 mm Hg to 38 +/- 1.2 mm Hg (P less than 0.001). Hematocrit fell from 56 +/- 2.5% to 50 +/- 1.2%, a mean fall of 6% (P less than 0.01), during medroxyprogesterone acetate therapy. In the 2 patients who had cardiac catheterization before and during medroxyprogesterone acetate therapy, mean pulmonary arterial pressure fell 13 and 19 mm Hg. There were no recurrences of cor pulmonale during treatment. These effects on arterial blood gas values and clinical state were sustained during therapy. On withdrawal of medroxyprogesterone acetate during 1-month period, arterial oxygen and carbon dioxide tensions deteriorated to their previous pretreatment values. Reinstitution of medroxyprogesterone acetate caused improvement in both the oxygen and carbon dioxide tensions. We conclude that sublingual medroxyprogesterone acetate therapy is useful in the management of the Pickwickian syndrome.
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PMID:Progesterone for outpatient treatment of Pickwickian syndrome. 110 59

Most patients with extreme obesity do not exhibit alveolar hypoventilation, but an intriguing minority do. The mechanism(s) of this phenomenon remain unknown. A disorder in ventilatory control has been suggested as a major factor in the pathogenesis of the obesity-hypoventilation syndrome. Accordingly, hypoxic and hypercapnic ventilatory drives were measured in 10 patients with the typical symptoms of the syndrome: obesity, hypersomnolence, hypercapnia, hypoxemia, polycythemia and cor pulmonale. Hypoxic ventilatory drive, measured as the shape parameter A, averaged 21.9 +/- 5.35, approximately one-sixth that in normal controls, A = 126 +/- 8.6 (P less than 0.01). The ventilatory response to hypercapnia also was markedly reduced, the slope of the response averaging 0.51 +/- 0.005, or about one-third the normal value of 1.83 +/- 0.13 (P less than 0.01). This decreased responsiveness in hypoxic and hypercapnic ventilatory drive was consistent throughout the group. The depression in ventilatory drive found in the obesity-hypoventilation syndrome may be causally related to the alveolar hypoventilation manifested by these patients.
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PMID:Decreased hypoxic ventilatory drive in the obesity-hypoventilation syndrome. 116 44


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