Abstract:
:In order to determine which patients with congestive heart failure (CHF) develop Cheyne-Stokes respiration (CSR) during sleep, we compared the cardiorespiratory profiles of CHF patients with CSR to those of CHF patients without CSR. Overnight polysomnography and continuous transcutaneous PCO2 (tc PCO2) monitoring, estimation of left ventricular ejection fraction (LVEF), pulmonary function tests, and chest radiograph were performed on 16 consecutive patients with chronic, stable CHF. The tc PCO2 monitor (Kontron 7640) was calibrated so that measurements reflected arterial PCO2 values. A mean value was calculated for wakefulness (W) and total sleep time (TST). Circulation time (CT) from the lung to the carotid body was estimated from the end of an apnea or voluntary breath-hold to the nadir of oxygen desaturation recorded on an ear oximeter. The duration of CSR was expressed as a percent of TST. Nine patients developed CSR during sleep (52.5 +/- 31.6 percent TST) (group 1) and 7 did not (group 2). All patients were male and both groups were a similar age (64 +/- 8 vs 63 +/- 4 years) and weight (body mass index, 28.1 +/- 3.5 vs 25.4 +/- 3.4 kg/m2). There were no significant intergroup differences between LVEF (22 +/- 5.2 vs 24.1 +/- 5.2 percent), CT (19.1 +/- 3.6 vs 15.9 +/- 6.7 s), SaO2 (W) (94 +/- 1.2 vs 92.4 +/- 2.1 percent), and SaO2 (TST) (90.8 +/- 2.7 vs 92.4 +/- 2.1 percent). The tc PCO2 (W) was lower in group 1 (34.4 +/- 3.5 vs 38.1 +/- 1.9 mm Hg), increased during sleep by a similar amount in both groups (1.6 +/- 1.5 vs 2.1 +/- 2.2 mm Hg), and was significantly lower during sleep in group 1 (36.1 +/- 3.4 vs 40.2 +/- 2.2 mm Hg). We conclude that CHF patients with CSR hyperventilate during sleep and wakefulness and that CHF patients with awake hypocapnia are more likely to develop CSR during sleep. These findings indicate that arterial PCO2 is important in determining which CHF patients develop CSR.
journal_name
Chestjournal_title
Chestauthors
Hanly P,Zuberi N,Gray Rdoi
10.1378/chest.104.4.1079subject
Has Abstractpub_date
1993-10-01 00:00:00pages
1079-84issue
4eissn
0012-3692issn
1931-3543pii
S0012-3692(16)37291-9journal_volume
104pub_type
杂志文章相关文献
CHEST文献大全abstract:STUDY OBJECTIVES:Autopsy evaluation of tracheobronchomalacia (TBM) in patients with Duchenne muscular dystrophy (DMD) who were receiving long-term ventilation through uncuffed tracheostomies. DESIGN:Necropsies were performed in seven patients with DMD who had received positive-pressure ventilation through uncuffed tra...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.4.1307
更新日期:2003-04-01 00:00:00
abstract::In a double-blind crossover controlled study, intravenous (IV) or nebulized terbutaline was given to eight patients with moderately severe asthma on two separate days. Four incremental doses of terbutaline were given by each route to establish a maximal effect. Both routes of administration produced significant increa...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.79.5.506
更新日期:1981-05-01 00:00:00
abstract::Workers exposed to a variety of wood dusts have been shown to exhibit occupational asthma, lung function deficits, and elevated levels of respiratory symptoms. Despite the popularity of pine and spruce, the health effects of exposures to these woods have not been extensively investigated. A study was undertaken to inv...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.3.642
更新日期:1995-09-01 00:00:00
abstract::Previous studies on the bronchodilating effect of nitrates yielded conflicting results. We hypothesized that the concomitant bronchial vasodilatation induced by nitrates may limit the increase of airway patency due to bronchial smooth muscle relaxation. To test this hypothesis, we evaluated the bronchodilating effect ...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.107.1.169
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:In chronic obstructive pulmonary disease, both smaller and larger airways are affected. FEV1 mainly reflects large airways obstruction, while the later fraction of forced exhalation reflects reduction in terminal expiratory flow. In this study, the objective was to evaluate the relationship between spirometr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.06.047
更新日期:2016-11-01 00:00:00
abstract::We describe three cases of acute uncomplicated bacterial pneumonia due to viridans streptococci in previously healthy adults, which were indistinguishable from those caused by other well-known respiratory pathogens. On arrival, all of these patients were treated with IV aqueous penicillin based on Gram stain of sputum...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.4.831
更新日期:1989-10-01 00:00:00
abstract::Bronchoscopy specimens from 183 known/suspected acquired immunodeficiency syndrome patients were evaluated for pathogens. In each case, transbronchial biopsies were evaluated and bronchoalveolar lavage material was cultured for viruses, fungi and mycobacteria and examined cytologically. A specimen was considered posit...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.1.24
更新日期:1990-07-01 00:00:00
abstract::Bronchopulmonary endometriosis is a rare cause of hemoptysis. We describe a woman with catamenial hemoptysis which was localized with chest CAT scanning and treated successfully with danazol. The proposed pathogenesis and manifestations of thoracic endometriosis are reviewed, and the use of new diagnostic and therapeu...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.87.5.687
更新日期:1985-05-01 00:00:00
abstract::Bronchial epithelial damage and mucus hypersecretion are characteristic features of chronic airway inflammation that can impair mucociliary clearance and can cause recurrent or persistent respiratory infection. In response to chemoattractants produced by damaged or inflamed tissue, neutrophils move through sequential ...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.125.2_suppl.41s
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Carotid arteriosclerosis and sleep apnea are considered as independent risk factors for stroke. Whether sleep apnea mediates severity of carotid stenosis remains unclear. Sleep apnea comprises two pathophysiologic conditions: OSA and central sleep apnea (CSA). Although OSA results from upper airway occlusion...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-1655
更新日期:2015-04-01 00:00:00
abstract::Systemic embolization is a common complication of left atrial myxoma; however, coronary embolism leading to acute myocardial infarction is rare. The use of echocardiography has increased the detection of intracardiac tumors when signs and symptoms are not evident. Echocardiography is the diagnostic procedure of choice...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.4.1106
更新日期:1996-04-01 00:00:00
abstract:BACKGROUND:Tranexamic acid (TA) is an antifibrinolytic drug currently used systemically to control bleeding. To date, there have been no prospective studies of the effectiveness of inhaled TA for the treatment of hemoptysis. OBJECTIVES:The goal of this study was to prospectively assess the effectiveness of TA inhalati...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.chest.2018.09.026
更新日期:2018-12-01 00:00:00
abstract::Patients with HES and pulmonary infiltrates may pose certain diagnostic problems as the infiltrates may be attributed to infection, infarction, congestive heart failure, or HES itself. We report an 87-year-old woman with idiopathic HES presenting with bibasal alveolar infiltrates. Differential cell count in BAL fluid ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.4.1178
更新日期:1992-04-01 00:00:00
abstract::A 17-year-old girl with primary pulmonary hypertension was treated with longterm administration of oxygen. Oxygen was delivered only at night for eight hours daily. Her clinical status has been improved for more than 17 months. Cardiac catheterization revealed almost 50 percent reduction of pulmonary vascular resistan...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.74.3.299
更新日期:1978-09-01 00:00:00
abstract::Two patients had a vessel-like aortopulmonary "window" which could be ligated without the institution of cardiopulmonary bypass. While embryologically and functionally these communications are identical to the classic aortopulmonary "window," it is suggested that the term "aortopulmonary communication" is more appropr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.75.3.397
更新日期:1979-03-01 00:00:00
abstract::The effects of six weeks of threshold pressure inspiratory muscle training (IMT) on inspiratory muscle performance, breathing pattern and exercise performance were studied in eight patients with severe airflow obstruction. The results indicated that IMT improved inspiratory muscle performance but did not affect exerci...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.3.535
更新日期:1989-03-01 00:00:00
abstract::The Bayesian analysis was used in this study to investigate the diagnostic value of the bronchial provocation test with methacholine in patients with asthma. The best cutoff value of accumulated concentration of methacholine administered that caused a 20 percent fall in FEV1 post-saline (PC20) in our sample, determine...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.1.149
更新日期:1993-07-01 00:00:00
abstract::A 60-year-old man with massive hemoptysis was treated successfully by modified bronchoscopic balloon tamponade technique. Compared with previously reported techniques, the modified technique requires no special catheter, no complicated maneuver, and is able to be applied to more massive bleeding. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.109.3.842
更新日期:1996-03-01 00:00:00
abstract::Three young men died of rapidly progressive pulmonary edema of delayed onset after inhalation of fumes from an accidental nitric acid explosion. Electron microscopy revealed altered neutrophils and necrotic endothelial cells in alveolar capillaries. Immunohistochemistry showed small and large serum proteins, including...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.2.487
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Cough provides high expiratory airflows to aerosolize and remove material that cannot be adequately removed by ciliary action. Cough is particularly important for clearing foreign particles from the airway in those with dysphagia who may be at risk for penetration/aspiration (P/A). Expiratory muscle strength...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1389
更新日期:2009-05-01 00:00:00
abstract:CASE PRESENTATION:A 32-year-old Nigerian woman, who became pregnant after undergoing in vitro fertilization, was admitted with nausea and abdominal pain. She had a history of two miscarriages and infertility because of tubal blockage treated by salpingectomy. One week prior, she presented to an outside hospital with pr...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.10.001
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The protein deacetylase sirtuin-1 (SIRT1) is an antiaging molecule that is decreased in the lung in patients with COPD. Recently, SIRT1 was reported to be detectable in serum, but serum SIRT1 (s120S) levels have not yet been reported in patients with COPD. METHODS:Serum SIRT1 protein of all samples was meas...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2017.05.004
更新日期:2017-08-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the efficacy of the chest radiograph in identifying patients with miliary tuberculosis. DESIGN:Retrospective case-controlled review by three independent blinded chest radiologists. SETTING:Provincial tuberculosis control center. PATIENTS:Population-based sample, including all proved cases o...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.110.2.339
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To highlight the incidence of subglottic stenosis (SGS) as a complication of surgery for congenital heart disease and the role of single-stage laryngotracheoplasty in treating this complication. DESIGN:Retrospective case series. SETTING:University-based referral center specializing in surgery for congenital...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.6.1769
更新日期:1997-06-01 00:00:00
abstract::A 20-year-old woman developed severe shortness of breath 4 h after a cesarean section. Chest roentgenogram showed a pleural effusion and tension pneumothorax; insertion of a chest tube drained liquid stool. At surgery she was found to have a left diaphragmatic defect with herniation, strangulation, and perforation of ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.3.950
更新日期:1993-03-01 00:00:00
abstract:STUDY OBJECTIVES:Pulmonary rehabilitation (PR) that includes exercise training can improve exercise tolerance and quality of life for patients with COPD. However, the degree of benefit from PR is variable. We hypothesized that the exercise response to PR varies depending on the initial factors that limit exercise. DES...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.127.1.110
更新日期:2005-01-01 00:00:00
abstract::The effect of combined administration of different dose ratios of dobutamine (DB) and dopamine (DA) (DB/DA ratio of 1:1; 1.5:0.5; 2:0; 0.5:1.5; and 0:2), with the added dose kept constant (10 micrograms/kg/min-20 micrograms/kg/min), on right ventricular function (measured by the thermal washout method with the aid of ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.5.1197
更新日期:1992-05-01 00:00:00
abstract::alpha 1-Antitrypsin (alpha 1-AT) accumulates in the rough endoplasmic reticulum through a mechanism of polymerization. Polymerization is favored by the incorrect tertiary structure of the alpha 1-AT caused by a point mutation at position 342 of the protein. Accumulation of alpha 1-AT in the liver cells (and in hepatoc...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.110.6_supplement.251s
更新日期:1996-12-01 00:00:00
abstract::Arterial blood samples from 75 patients were analyzed for PO2, PCO2, and pH at 0, 15, and 30 min. After the baseline analysis, 60 samples were kept in ice while 59 samples were left at room temperature. There was a statistically significant increase in the PO2 at 15 min and again at 30 min in both groups. There was a ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.4.1120
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study is to determine the accuracy of the cuff-leak test in a cardiovascular ICU. METHODS:Five hundred twenty-four patients were tested immediately before being extubated 531 times. The cuff-leak test was performed with the ventilator set in assist-control mode at a tidal volume (VT) of 1...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.4.1029
更新日期:1999-10-01 00:00:00