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

This paper analyzes the craniofacial morphology in a patient with typical Hallermann-Streiff syndrome (HSS) who developed symptomatic cardiorespiratory deficiency at the age of 48 years. The patient had obstructive sleep apnea (OSA), hypoxia, hypercarbia, pulmonary hypertension, tricuspid insufficiency, and right ventricular failure. Analysis of cephalometric roentgenograms, done 15 years earlier, revealed severe mandibular hypoplasia with marked underdevelopment of the ramus and body. The gonial angle was abnormally obtuse. The condylar and coronoid processes were reduced in size. The anteroposterior dimension of the upper airway was markedly narrowed. Cephalometric roentgenograms of six other HSS patients from our clinic were compared to those of the reference patient. Considerable variation in the features of the syndrome were noted. None of the other patients showed definitive airway obstruction. Comparison was also made with cephalometric roentgenograms of a patient with Treacher Collins syndrome and of a patient with progeria. The former showed airway obstruction associated with a deformed hypoplastic mandible; the latter had an unobstructed airway despite a small mandible because of associated hypoplasia of the maxilla and tongue. The HSS reference patient improved after oxygen therapy, diuretics, antibiotics, and relief of OSA. Patients with HSS, as well as those with Treacher Collins syndrome, appear to be at risk for the development of cardiopulmonary disease if they have obstructed airways. OSA has been shown to have developed in two patients with HSS. The resultant cardiopulmonary insufficiency of such patients may be preventable if airway obstruction can be relieved relatively early in life.
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PMID:Cardiorespiratory disease associated with Hallermann-Streiff syndrome: analysis of craniofacial morphology by cephalometric roentgenograms. 387 95

Five infants with Pierre Robin syndrome developed evidence of carbon dioxide retention and congestive cardiac failure despite measures to alleviate upper airway obstruction. Investigations included chest radiography, electrocardiography, echocardiography, and cardiac catheterization; pulmonary hypertension was diagnosed. In two cases raised main pulmonary artery pressures of 40 mm Hg and 120 mm Hg were recorded. Relief of upper airway obstruction was achieved by tracheostomy in three cases and nasopharyngeal intubation in two cases, with reversal of signs of cor pulmonale in each. Four patients progressed well with no recurrence of cardiac problems but one died suddenly one month after apparently successful management by tracheostomy.
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PMID:Pierre Robin syndrome and pulmonary hypertension. 388 27

The clinical and physiologic features of 28 infants with Pierre Robin syndrome and those of 20 infants with various types of nasal obstruction were reviewed to determine whether different causes of upper airway obstructure may lead to a common syndrome. The patients had no significant differences in distribution of main clinical manifestations. Their features included cyanosis with respiratory distress, apneic spells, oropharyngeal dysphagia, vomiting, failure to thrive, cor pulmonale, brain damage, and sudden death during sleep. The common physiologic manifestation appeared to be an oropharyngeal obstruction caused by glossoptosis, which occurred mainly during wakefulness. Upper airway obstruction led to hypoxemia, which, in many instances, was not associated with hypercapnia and was not relieved by oxygen administration. It is concluded that regardless of a specific cause, any airway obstruction that results in a decreased inspiratory pressure overcoming the airway maintaining genioglossus action causes a glossoptosis-apnea syndrome.
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PMID:Glossoptosis-apnea syndrome in infancy. 399 Dec 69

The response of ventilation and of heart rate to hypoxia and hypercapnia was determined in eight young normal men age 22-30 yr and eight elderly men age 64-73. The elderly men were selected and carefully screened to eliminate the possibility of cardiopulmonary disease. All the subjects were born at low altitude and had no significant prior exposure to hypoxia. The ventilatory response to hypoxia was measured as the exponential slope constant. k, of regression lines relating the logarithm of incremental ventilation to PAo(2) during isocapnic progressive hypoxia. The heart rate response to hypoxia was measured as the percentage change in heart rate between PAo(2) = 100 and PAo(2) = 40 mm Hg. The ventilatory response to hypercapnia was measured as the slope of regression lines relating ventilation to PAco(2) during rebreathing with PAo(2) > 200 mm Hg. The heart rate response to hypercapnia was measured as the percentage change in heart rate between control values at the start of the rebreathing test and PACO(2) = 55 mm Hg. The ventilatory and heart rate responses to both hypoxia and hypercapnia were significantly decreased in the elderly men as compared to the young men. Hypoxic ventilatory drive was decreased by 51+/-6% (mean +/-SEM: P < 0.001) and hypercapnic drive by 41+/-7% (P < 0.025). The percentage change in heart rate produced by hypoxia was 34+/-5% (mean +/-SEM) in the young normals and 12+/-2% in the old normals (P < 0.005). Similar figures for heart rate in response to hypercapnia were 15+/-3% and -1+/-1% for the young and old normal groups (P < 0.001). We conclude that ventilatory and heart rate responses to hypoxia and hypercapnia diminish with age. These alterations in both ventilatory and circulatory controls could make older individuals more vulnerable to hypoxic disease states.
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PMID:Attenuation of the ventilatory and heart rate responses to hypoxia and hypercapnia with aging in normal men. 471 63

Very few therapeutic measures of proven effectiveness are available for the management of chronic bronchitis with chronic respiratory failure. Long-term oxygen therapy undoubtedly improves functional and vital prognoses in patients with severe hypoxaemia (55 less than or equal to PaO2 less than or equal to 60 mmHg) or chronic post-hypoxia cor pulmonale, but its indications are limited by its cost and by numerous practical problems. Owing to its mode of action and pharmacological effects, almitrine bismesylate corrects the main physiopathological disorders underlying hypoxaemia and its complications in chronic bronchitis. Improvement in arterial and tissue oxygen supply and decrease in hypercapnia result from the specific and original action of the drug on the distribution of alveolar ventilation-perfusion ratios--an action that has been clearly demonstrated by the inert gas method and by radioisotopic techniques. Such a mode of action differentiates almitrine bismesilate from long-term oxygen therapy which has similar effects, at least qualitatively, on tissue oxygenation. The lack of undesirable effects on central nervous system, pulmonary circulation and respiratory mechanics confirms the originality and safety of a drug which unquestionably constitutes a novel and major contribution to the long-term treatment of chronic bronchitis with hypoxaemia.
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PMID:[Originality of the mode of action of almitrine dimesylate]. 614 36

When administered orally, in the usual doses, to chronic bronchitis patients with hypoxaemia and hypercapnia, almitrine bismesylate corrects blood gas disturbances without producing significant changes in haemodynamic and spirometric values. This effect betrays a specific action on the alveolar ventilation/perfusion imbalance responsible for hypoxaemia. The original mode of action of the drug and its clinical and biological effectiveness demonstrated in long-term treatment, as well as its safety, offer new hopes for the management of chronic bronchitis. The possibility of acting on hypoxaemia conveniently and at an early stage should be expected to delay the development of cor pulmonale, but this remains hypothetical and needs to be confirmed, in spite of strong physiopathological bases, by strictly controlled therapeutic trials. It cannot be definitely stated, at this stage, that almitrine will entirely replace continuous low flow rate oxygen therapy, yet it is already certain that the indications for the latter ought to be re-evaluated for physiopathological, practical and financial reasons.
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PMID:[Almitrine dimesylate: deductions and therapeutic prospects]. 614 39

Left ventricular function was studied at rest and during post-extrasystolic potentiation (PESP) in 18 patients with chronic obstructive lung disease. The contractility indices were obtained from pressures recorded in the osovolumetric period and from volume variations during ejection. All patients were hypoxic; six of them had cor pulmonale (group B); the remaining 12 patients constituted group A. Left ventricular function was similar in both groups; it is concluded that right heart failure in cor pulmonale is not secondary to left ventricular failure. Left ventricle was hypertrophied and pump function altered, but left ventricular kinetics was normal or increased. Isovolumetric phase contractility indices were decreased; they may increase during PESP. Left ventricular compliance was altered due to left and right ventricular hypertrophy and to paradoxical movement of interventricular septum which impeded diastolic expansion of left ventricle. The impairment of left ventricular function seems to be related to both intrinsic (hypoxia, hypercapnia, hypertrophy) and extrinsic factors (right ventricular hypertrophy with deviation of interventricular septum, lowering of left ventricular preload).
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PMID:Left ventricular function in chronic obstructive pulmonary disease. 645 29

Congenital central hypoventilation syndrome was diagnosed in an infant who since birth had shallow respiration and CO2 retention during sleep, absent ventilatory response to hypercarbia, and no underlying disease or trauma to account for the symptoms. Diaphragm pacing was started at the age of 8 1/2 months and has been successfully carried out at home, guided by end-tidal CO2 monitoring. After 22 months of home treatment, at the age of two years 9 months, linear growth and psychomotor development are progressing normally, while previous symptoms of cor pulmonale have not progressed.
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PMID:Congenital central hypoventilation syndrome treated with diaphragm pacing. 660 58

The development of right ventricular failure due to pulmonary hypertension is a common complication of severe chronic bronchitis and emphysema (Renzetti et al. 1976) but is rare in bronchial asthma (Clark 1977). We report a 20-year-old extrinsic asthmatic with persistent hypoxaemia and carbon dioxide retention, secondary polycythaemia and cor pulmonale and describe his further investigation.
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PMID:Cor pulmonale in asthma. 661 6

The response of ventilation to hypercapnia was determined in 10 normal young Nigerians, aged 19 to 30 years, and in eight elderly Nigerians, aged 50 to 65 years. The elderly subjects were carefully screened to eliminate the possibility of cardiopulmonary disease. All the subjects had been born in low-altitude areas and had not had prior exposure to hypoxia. The ventilatory response to hypercapnia was found to be significantly decreased in the elderly subjects. It is concluded that the ventilatory response to hypercapnia decreases with age among Nigerians.
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PMID:Relation between age and respiratory response to inhaled carbon dioxide in healthy Nigerians. 677 95


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