Disordered respiratory control in children with partial cerebellar resections
Disordered respiratory control in children with partial cerebellar resections
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DOI：
10.1002/ppul.20225
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发表时间：
2005-07-01
影响因子：
3.1
通讯作者：
Keens, TG
中科院分区：
文献类型：
--
作者：
Chen, ML;Witmans, MB;Keens, TG
虽然小脑在传统上并不被认为在呼吸控制中具有重要作用，但呼吸涉及需要小脑协调的循环运动行为。我们推测，部分小脑切除的儿童有呼吸控制障碍，由于改变了同步的小脑肌肉。我们回顾了36例因小脑肿瘤而接受小脑部分切除术的儿童。19%的患者P-aCO2值升高。6例患者在切除术后第一个月内记录到呼吸暂停或短呼吸事件。2例患者需要插管辅助通气，1例患者需要辅助通气7.3周。那些有呼吸暂停的人氧饱和度较低，需要补充氧气的时间较长。有呼吸暂停的患者比无呼吸暂停的患者年龄大。吞咽需要使用许多与维持上呼吸道通畅所需的肌肉相同的肌肉，在50%的呼吸暂停患者中功能障碍。我们的结论是，小脑切除术的儿童有呼吸暂停，通气不足，低氧血症的发生率增加，否则不能解释肺部疾病，有些需要长期辅助通气。我们推测，这些异常是由小脑协调功能障碍引起的呼吸控制改变的表现。(c)2005 Wiley-Liss，Inc.
While the cerebellum is not traditionally thought of as having an important role in respiratory control, breathing involves cyclic motor acts that require cerebellar coordination. We postulate that children with partial cerebellar resections have disordered respiratory control due to altered synchronization of ventilatory muscles. We reviewed the records of 36 children following partial cerebellar resections due to neoplasms confined to the cerebellum. P-aCO2 values were elevated in 19% of patients. Six patients had apneic or braclypneic events documented within the first month after resection. Two patients required intubation with assisted ventilation, and one needed assisted ventilation for 7.3 weeks. Those with apnea had lower oxygen saturations, and a longer need for supplemental oxygen. Patients with apnea were older than those without apnea. Swallowing, which uses many of the same muscles as those needed to maintain upper airway patency, was dysfunctional in 50% of those with apneas. We conclude that children with cerebellar resections have an increased incidence of apnea, hypoventilation, and hypoxemia not otherwise explained by pulmonary disease, and some require prolonged assisted ventilation. We speculate that these abnormalities are manifestations of altered respiratory control caused by dysfunctional cerebellar coordination of ventilatory muscles. (c) 2005 Wiley-Liss, Inc.