Journal of physiology and pharmacology : an official journal of the Polish Physiological Society
-
J. Physiol. Pharmacol. · Sep 2004
Outcomes of CPAP treatment in a sleep laboratory specialized in neuropsychiatry.
The rapidly increasing number of sleep laboratories implicates their specialization into various fields of sleep medicine. In our sleep laboratory that specializes in neuropsychiatry, patients with the symptoms typical for the obstructive sleep apnea/hypopnea syndrome (OSAHS) were routinely redirected to a local respiratory clinic. Some patients, however, admitted to our center for other reasons revealed OSAHS in nocturnal polysomnography. ⋯ In 1 patient no cause was identified. Our patients showed relatively mild sleepiness before CPAP and only a slight improvement under CPAP. The CPAP noncompliance seems the most prevailing reason for CPAP failure, but in some patients the cause of PTS could not be unraveled by using standard diagnostic tools and some additional measures are to be employed to resolve the issue.
-
J. Physiol. Pharmacol. · Sep 2004
ReviewNon-invasive ventilation in chronic obstructive pulmonary disease.
Non-invasive ventilation (NIV) via nasal or full face mask can be applied in respiratory failure due to chronic obstructive pulmonary disease (COPD) both in the acute and long-term settings. In acute exacerbation of COPD with respiratory failure it may be considered as a standard treatment. There is strong evidence that NIV might reduce intubation, complication, and mortality rate in patients with acute hypercapnia (PaCO(2) >45 mmHg). ⋯ Especially, COPD patients with substantial chronic hypercapnia (PaCO(2) >55 mmHg) and/or nocturnal hypoventilation, and those with repeated exacerbations may profit from NIV. In any case, NIV is a very valuable and effective tool in the non-pharmacological treatment of COPD. Every clinician who is involved in the management of COPD patients with respiratory insufficiency should be able to apply this technique.
-
J. Physiol. Pharmacol. · Sep 2004
Reflex respiratory responses to progressive hyperoxic hypercapnia and normocapnic hypoxia in normocapnic and hypercapnic obstructive sleep apnea patients.
Ventilatory responses to progressive hypercapnia were analyzed in the normocapnic and hypercapnic obstructive sleep apnea patients (OSA). The rebreathing hypercapnic and hypoxic tests were performed using the computerized equipment (Lungtest, MES), according to Read's method. The ventilatory response to hypoxia was impaired in all OSA patients. ⋯ Nine moderately hypercapnic OSA patients showed a right shift with a normal slope of the regression curve describing the relationship between the end-tidal PCO(2) and minute ventilation. In contrast, three severely hypercapnic OSA patients showed a right shift with a decreased slope of this regression curve. We conclude that awake OSA patients who developed hypercapnic ventilatory insufficiency showed an impaired hypercapnic defense reaction.