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Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea

Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or...

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Autores principales: TESTANI, E., DE CORSO, E., LOSURDO, A., FIORITA, A., VOLLONO, C., MARCA, G. DELLA, SCARANO, E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini Editore Srl 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265664/
https://www.ncbi.nlm.nih.gov/pubmed/30498277
http://dx.doi.org/10.14639/0392-100X-1476
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author TESTANI, E.
DE CORSO, E.
LOSURDO, A.
FIORITA, A.
VOLLONO, C.
MARCA, G. DELLA
SCARANO, E.
author_facet TESTANI, E.
DE CORSO, E.
LOSURDO, A.
FIORITA, A.
VOLLONO, C.
MARCA, G. DELLA
SCARANO, E.
author_sort TESTANI, E.
collection PubMed
description Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCO(2), which decreased from 52.3 mmHg before surgery to 42.0 mmHg after surgery. It is conceivable that, due to long-lasting severe OSAS, our patient lowered his chemosensitivity to PCO(2). Consequently, the resolution of obstructive apnoeas and the restoration of normal nocturnal values of PCO(2) may have reduced the nocturnal PCO(2) to the point of being inadequate to stimulate ventilation.
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spelling pubmed-62656642019-01-21 Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea TESTANI, E. DE CORSO, E. LOSURDO, A. FIORITA, A. VOLLONO, C. MARCA, G. DELLA SCARANO, E. Acta Otorhinolaryngol Ital Case Series and Reports Central sleep apnoea (CSA) is a lack of drive to breathe during sleep, which can occur in physiologic as well as in pathologic conditions. A particular type of CSA, defined treatment-emergent CSA (TECSA), may occur after the treatment of obstructive sleep apnoea syndrome (OSAS), either with CPAP or surgery. TECSA is transitory and seems to be related to the severity of OSAS. We describe a 51-year-old man affected by severe OSAS who developed severe, transient CSA immediately after upper airways surgery. We believe that CSA was triggered by the sudden variation in nocturnal arterial PCO(2), which decreased from 52.3 mmHg before surgery to 42.0 mmHg after surgery. It is conceivable that, due to long-lasting severe OSAS, our patient lowered his chemosensitivity to PCO(2). Consequently, the resolution of obstructive apnoeas and the restoration of normal nocturnal values of PCO(2) may have reduced the nocturnal PCO(2) to the point of being inadequate to stimulate ventilation. Pacini Editore Srl 2018-10 /pmc/articles/PMC6265664/ /pubmed/30498277 http://dx.doi.org/10.14639/0392-100X-1476 Text en Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to https://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Case Series and Reports
TESTANI, E.
DE CORSO, E.
LOSURDO, A.
FIORITA, A.
VOLLONO, C.
MARCA, G. DELLA
SCARANO, E.
Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title_full Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title_fullStr Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title_full_unstemmed Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title_short Treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
title_sort treatment-emergent central sleep apnoea after surgery for obstructive sleep apnoea
topic Case Series and Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265664/
https://www.ncbi.nlm.nih.gov/pubmed/30498277
http://dx.doi.org/10.14639/0392-100X-1476
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