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  • 1
    Electronic Resource
    Electronic Resource
    Influence of Orthotopic Heart Transplantation on Breathing Pattern Disorders in Patients with Dilated Cardiomyopathy (2000)
    Springer
    Sleep and breathing 4 (2000), S. 121-125 
    Details
    ISSN: 1522-1709
    Keywords: Cheyne-Stokes respiration ; dilated cardiomyopathy ; congestive heart failure ; heart transplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cheyne-Stokes respiration is well-known in patients with congestive heart failure. One of the causes might be a prolonged circulation time or diminished pulmonary gas stores. Improvement of cardiac function by heart transplantation might abolish Cheyne-Stokes respiration. We examined 29 male patients (age 24 to 63 years) with polysomnographically verified Cheyne-Stokes respiration before and 3 to 9 weeks after orthotopic heart transplantation. All patients suffered from congestive heart disease. Left ventricular ejection fraction (LVEF) was between 8 and 19% We analyzed sleep stages, respiratory events, oxygen saturation, and cardiac function (echocardiography and ergometry). Before heart transplantation all patients showed periodic breathing (apnea-hypopnea index [AHI] 13.2–51.6/h). Oxygen saturation dropped to a minimum of 63% Sleep was severely disturbed. After heart transplantation LVEF was significantly higher in all patients (xmean = 64%). Twenty-three of 29 patients showed no more evidence of periodic breathing. However, even with normalized cardiac function, 6 patients still suffered from Cheyne-Stokes respiration. Cheyne-Stokes respiration is often associated with dilated cardiomyopathy. Our results demonstrate that normalization of cardiac function improves Cheyne-Stokes respiration. Even after normalization of cardiac function, some patients suffer from Cheyne-Stokes respiration further on. We suggest that breathing control centers may be permanently damaged in these patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s11325-000-0121-y
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Continuous aerosol inhalation scintigraphy in the evaluation of early and advanced airways obstruction (1984)
    Springer
    European journal of nuclear medicine 9 (1984), S. 62-67 
    Details
    ISSN: 1619-7089
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract By means of continuous lung imaging, regional mucociliary removal rates of inhaled 99mTc-labeled human serum albumin minimicrospheres were determined over upper, middle, lower, central, and peripheral anterior lung areas. Additionally, an index was employed for analysis of initial pulmonary radioaerosol distribution in order to quantify the site of particle deposition in various degrees of airways obstruction. The study involved 15 volunteer healthy subjects, 20 asymptomatic smokers with early small airways obstruction, and 30 patients with advanced chronic obstruction of large airways. The healthy group showed evenly distributed lung activity and (normal) clearance rates consistent with data from earlier work. While most uneven lung aerosol distribution was seen in the patients with large airways obstruction, slowest mucociliary clearance velocity was encountered in the smokers with small airways dysfunction. The aerosol technique, if carefully controlled, can be a useful supplement to pulmonary ventilatory function testing, showing reduction of bronchial mucous velocity to be one of the earliest signs of functional impairment in asymptomatic cigarette smokers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00254438
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Improvement of CPAP Therapy by a Self-Adjusting System (2000)
    Springer
    Sleep and breathing 4 (2000), S. 169-172 
    Details
    ISSN: 1522-1709
    Keywords: sleep apnoea syndrome ; CPAP therapy ; forced oscillation technique ; self adjusting therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The first generation of Auto CPAP devices caused respiratory arousal by apnoes, hypopnoeas, incomplete obstructions and pressurechanges. The new, second generation of CPAP devices which is based on forced oscillation technique will change the pressure with slower velocity and before the respiratory arousal reaction will occur (1, 9, 10). Fifty patients with severe sleep apnoea (AHI 66±26 /h) were treated with both, constant- CPAP (continous positive airway pressure) or Auto CPAP under polysomnographic control in a randomised order. The Auto CPAP based on forced oscillation technique reduced the number of apnoeas and hypopnoeas as did most of the other Auto CPAP systems to AHI 2.5±5.9 /h (p〈0.05). In comparison to Auto CPAP of the first generation it also decreased the number of respiratory arousal reactions caused by apnoeas and hypopnoeas. However there is still a significant difference to number of arousal detected with constant CPAP (p〈0.01). In conclusion although the new generation of Auto CPAP reduced the number of respiratory arousals compared to first generation, we did not find a therapeutical benefit for patients with severe SAS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s11325-000-0169-8
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Sleep-Breathing Disorders and Heart Failure (2000)
    Springer
    Sleep and breathing 4 (2000), S. 103-111 
    Details
    ISSN: 1522-1709
    Keywords: sleep apnea ; Cheyne-Stokes respiration ; chronic heart failure ; dilated cardiomyopathy ; congestive heart failure ; oygen therapy ; continous positive airway pressure (CPAP) ; theophylline
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Cheyne-Stokes respiration is known to be associated with severe left heart failure. Because of severe desaturation, sleep fragmentation, arousals, and an increase in sympathetic activity, Cheyne-Stokes respiration may lead to a further impairment of cardiac function and to a worsening of quality of life. Although the pathology of Cheyne-Stokes respiration is not fully understood, enhanced chemoreceptor sensitivity, prolonged circulation time, as well as decreased pulmonary gas stores and increased ventilatory drive may be contributing factors. Therapeutic options include the improvement of cardiac failure; medical treatment, such as using theophylline; continous positive airway pressure ventilation; and low-flow oxygen supply. Because of severe cardiac insufficiency, change of endothoracic pressure may worsen the hemodynamic situation in some patients. Therefore, this form of treatment has to be used carefully. Another possible treatment is a low-flow oxygen supply, which will prevent severe desaturations. This therapeutic approach might be a good alternative to noninvasive ventilation. However, it is controversial whether oxygen supply will improve quality of sleep of the patients, even in long-term treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s11325-000-0103-0
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  • 5
    Electronic Resource
    Electronic Resource
    Influence of Low-Flow Oxygen Supply on Sleep Architecture in Patients with Severe Heart Failure (NYHA III-IV) and Cheyne-Stokes Respiration (2000)
    Springer
    Sleep and breathing 4 (2000), S. 113-120 
    Details
    ISSN: 1522-1709
    Keywords: Cheyne-Stokes respiration ; dilated cardiomyopathy ; congestive heart failure ; oxygen supply ; sleep architecture
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Patients suffering from severe heart failure may develop breathing pattern disorders during sleep, especially in the form of Cheyne-Stokes respiration. Results may be severe disturbances in sleep architecture and worsening of hemodynamics and of prognosis of these patients. Causes of the periodic breathing disorders are probably hypocapnia, hypersensitivity of respiratory control centers, hypoxemia, and prolonged blood circulation time. This study examined the influence of different concentrations of continously administered oxygen during the nighttime on breathing pattern disorders, oxygen saturation, and sleep architecture in 65 patients with severe heart failure (NYHA III–IV). Fifty-two of 65 patients showed an improvement of sleep architecture. Total sleeping time increased significantly (p 〈 0.01). Fragmentations of sleep by arousals decreased (p 〈 0.01); time of random eye movement (REM) sleep and non–REM sleep III and IV increased significantly.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s11325-000-0113-y
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    Paper (German National Licenses)
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