22 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (4)

Williams and Braunwald reported a 20 percent incidence of moderate hypertension in the general adult suburban white population. In neither the study population as a whole nor the postpolio subpopulation did the incidence of moderate hypertension reach the level of statistical significance by a one-tailed binomial test when compared with the figures of Williams and […]

21 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (3)

The 15 symptomatic patients had significantly lower mean Sa02 values and more 4%dSa02 episodes per hour while using BVs than did the asymptomatic patients (89.9±8.0 vs 96±1.4 [p<0.02] and 25.6± 16.9 vs 2.63±4.4 [p<0.0001], respectively). Significant improvements in Sa02 were noted for 20 of the 22 patients who switched from a BV to NV-PAP (Table […]

20 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (2)

Of the five patients, only two (patients 22 and 33) were successfully switched to nocturnal NV-PAP In one case (patient 7) this did not, however, correct the dSa02. Three symptomatic patients with more than ten 4%dSa02 episodes per hour also used inadequate periods of daytime aid and did not maintain normal daytime blood gas values […]

19 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (1)

The 18 BV-assisted patients with a mean Sa02 of ^95 percent had a mean of 2.4 ±3.1 4%dSaC>2/h. The 19 BV-assisted patients with a mean Sa02 of <95 percent had a mean of 22.3 ± 15.5 4%dSa(Vh, including 13 with a mean of more than ten 4%dSaO<j/h (Table 1). Five of the 18 patients with […]

18 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (9)

All 37 patients underwent at least one night of Sa02 monitoring on BV assistance with a pulse oximeter with an internal printer (Model 3760, Ohmeda, Louisville, Colo). The 22 patients who were subsequently switched to nocturnal NV-PAP had at least one night of Sa02 monitoring on NV-PAP (Table 2). The overnight mean, low, and worst-hour […]

17 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (8)

Each patient was further examined for history of systemic hypertension and use of antihypertensive Canadian medications prior to, during, and, when appropriate, subsequent to BV use. All patients underwent general pulmonary function testing and had primarily restrictive pulmonary syndromes with no significant obstructive component. The day of the initial sleep study, the VC was redetermined […]

16 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (7)

The symptoms included, most commonly, fatigue, morning headaches, and hypersomnolence. The remaining 22 patients were evaluated during an initial trial of BV use or during a routine follow-up. The diagnoses in the 37 white patients were as follows: postpoliomyelitis (n = 22), traumatic quadriplegia (n = 7), non-Duchenne myopathy (n = 3), Duchenne muscular dystrophy […]

15 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (6)

George et al demonstrated that the number of episodes of dSa02 of greater than 3 percent that last for at least 10 s and that have a particular slope predicts the total number of poly-somnographically derived apneas and hypopneas with 98 percent sensitivity and very few false positives and false negatives. We manually counted the […]

14 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (5)

The untoward effects of OSAS appear to result primarily from dSaOjj. Chronic intermittent catecholamine release associated with periods of hypoxia and chronic sympathetic stimulation may play a role in the apparent increased incidence of systemic hypertension in OSAS. Its incidence was 58 percent in four studies of a total of 461 patients. The adverse effects […]

13 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (4)

The reflex activity of the dilator muscles of the upper airway, which normally occurs at the onset of active inspiration, may be inhibited by many factors, including the onset of REM sleep. Typical REM episodes of dSa02 are 6- to 18-s drops of 3 to 5 percent below the normal baseline Sa02, which is 95 […]

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