DEPRESSED VENTILATORY LOAD COMPENSATION IN SLEEP-APNEA - REVERSAL BY NASAL CPAP
DEPRESSED VENTILATORY LOAD COMPENSATION IN SLEEP-APNEA - REVERSAL BY NASAL CPAP
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DOI：
10.1164/ajrccm/148.6_pt_1.1610
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发表时间：
1993-12-01
期刊：
影响因子：
--
通讯作者：
SCHARF, SM
中科院分区：
文献类型：
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作者：
GREENBERG, HE;SCHARF, SM
吸气负荷代偿异常可能是导致阻塞性睡眠呼吸暂停（OSA）发生的原因之一。或者，睡眠负荷补偿异常可能是OSA表现的结果。本研究旨在确定OSA患者是否存在清醒吸气负荷补偿受损，并确定该参数的异常是否可通过鼻CPAP治疗逆转。设计了一种用于评估清醒吸气负荷补偿的新技术，以标准化在每个受试者的负荷补偿评估期间应用的吸气刺激程度。这消除了测试过程中受试者之间的刺激程度差异，这是标准技术不可避免的，并且已被证明会影响负载补偿的测量。在休息室空气通气期间和稳态CO2期间评估吸气负荷补偿，并滴定运动刺激，以在每例受试者中提供相似程度的吸气刺激。与体重匹配的对照组相比，中度至重度OSA患者在所有条件下均发现清醒吸气负荷补偿受损。清醒吸气负荷补偿正常化后，观察了5例患者的鼻CPAP治疗4周。这些结果表明，清醒吸气负荷补偿的损害是一个可逆的后果，而不是阻塞性睡眠呼吸暂停的原因。
Abnormal inspiratory load compensation may be one factor leading to development of obstructive sleep apnea (OSA). Alternatively, abnormalities in ventilatory load compensation may be a consequence of the manifestations of OSA. This investigation was designed to determine if impairment of awake inspiratory load compensation exists in OSA and to determine if abnormalities in this parameter are reversible by nasal CPAP therapy. A new technique for assessment of awake inspiratory load compensation was devised to standardize the degree of ventilatory stimulation applied during load compensation assessment in each subject. This eliminates intersubject differences in degree of ventilatory stimulation during testing, which are inevitable with standard techniques and which have been shown to affect the measurement of load compensation. Inspiratory load compensation was assessed during resting room air ventilation and during steady state CO2 and exercise stimulation titrated to provide similar degrees of ventilatory stimulation in each subject. Impairment of awake inspiratory load compensation was found during all conditions in the patients with moderate to severe OSA studied compared with that in weight-matched control subjects. Normalization of awake inspiratory load compensation was observed after 4 wk of nasal CPAP therapy in five patients. These results indicate that impairment of awake inspiratory load compensation is a reversible consequence rather than a cause of OSA.