肺毛细血管压对心力衰竭中中央呼吸暂停的影响
P Solin1, P Bergin, M Richardson
1Department of Respiratory Medicine, The Alfred Hospital, Prahran, Melbourne, Victoria, Australia.
Circulation
|March 30, 1999
概括
患有中心睡眠呼吸暂停的充血性心力衰竭患者有较高的肺毛细血管压 (PCWP). 增加的PCWP与中枢呼吸暂停严重程度和低头相关,这表明心力衰竭和呼吸障碍之间存在联系.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 急性肺堵塞与高通风,低头和中央睡眠呼吸暂停有关.
- 慢性肺堵塞在充血性心力衰竭 (CHF) 和中央睡眠呼吸暂停之间的关联仍然不清楚.
- 这项研究研究了肺毛细血管压 (PCWP) 和心肺炎患者中枢性呼吸暂停之间的关系.
研究的目的:
- 为了确定中枢性呼吸暂停的CHF患者是否比没有中枢性呼吸暂停的患者具有更高的PCWP.
- 评估PCWP与中央呼吸暂停的严重程度之间的相关性.
- 探索PCWP,低头和中央呼吸暂停频率之间的关系.
主要方法:
- 七十五名稳定的CHF患者接受了右心导管治疗和夜间睡眠研究.
- 患者被分为几组:中央呼吸暂停,阻塞性呼吸暂停或非呼吸暂停 (呼吸暂停-呼吸暂停指数<5).
- 肺毛细管压力 (PCWP) 和动脉二氧化碳水平 (PaCO2) 被测量并与呼吸暂停严重程度 (AHI) 相相关.
主要成果:
- 与阻塞性呼吸暂停 (12.3 mmHg) 和非呼吸暂停 (11.5 mmHg) 组相比,中央呼吸暂停组 (22.8 mmHg) 的平均PCWP显著更高 (P<0.001).
- 在中央呼吸暂停组中,PCWP与呼吸暂停严重程度 (AHI,r=0.47,P=0.006) 有正相关,与PaCO2 (r=-0.42,P=0.017) 有负相关.
- 7名患者的密集医学治疗减少了PCWP和中央呼吸暂停频率.
结论:
- 升高的PCWP是患有中枢呼吸暂停的CHF患者的特征.
- 在PCWP,低头,以及中枢睡眠呼吸暂停的频率和严重程度之间存在显著的关系.
- 这些发现突显了心脏功能与心力衰竭中呼吸控制之间的相互作用.
相关概念视频
Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
Measurement of Blood Pressure
Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Other Factors Affecting Respiration Centers
Breathing is primarily an involuntary activity regulated by the brainstem respiratory centers. However, it can also be consciously controlled, allowing us to hold our breath or take deeper breaths when needed. This voluntary control is facilitated by the cerebral motor cortex, which bypasses the medullary centers to stimulate the respiratory muscles directly.
However, the ability to hold one's breath voluntarily is not limitless. When the CO2 concentration in the blood reaches a critical level,...
However, the ability to hold one's breath voluntarily is not limitless. When the CO2 concentration in the blood reaches a critical level,...
Acute Respiratory Failure-IV
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
Pneumothorax-I
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pulmonary Embolism I: Introduction
Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...


