Dynamic CO? inhalation: a novel treatment for CSR-CSA associated with CHF.

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摘要：

BackgroundCheyne–Stokes respiration with central sleep apnea (CSR–CSA) is very common in patients with chronic congestive heart failure (CHF). A current concept of the key pathophysiological mechanism leading to CSR–CSA is a fluctuation of PaCO below and above the apneic threshold. A number of therapeutic approaches for CSR–CSA have been proposed—all with varying success, some of which include various modes of positive airway pressure among other strategies. However, CO oscillations seen in CSR–CSA have yet to be looked at as a specific therapeutic target by current treatments.DiscussionPrevious studies have shown that delivery of constant CO is efficacious in eliminating CSR–CSA by raising PaCO, but there are serious concerns about the potential side effects, such as unwanted elevations in ventilation, work of breathing, and sympathetic nerve activity (SNA), and consequently CO inhalation therapy has not been recommended as a routine option for therapy. However, recent new studies into CO inhalation therapy have been made that may reshape its role as therapeutic. In this review, we will focus on the recent developments of administration of dynamic CO in the management of CSR–CSA in CHF patients.

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关键词：

Cheyne–Stokes respiration Central sleep apnea Heart failure Inhaled carbon dioxide Treatment

DOI：

10.1007/s11325-012-0719-x

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年份：

2013