Posthyperventilation Apnea Associated with Severe Hypoxemia

MacDonald, Kyle; Bowers, Jessie; Flynn, Robert E.

doi:10.1378/chest.70.4.554

Cited by 15 publications

(13 citation statements)

References 14 publications

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“…Apnea and loss of consciousness in patients with HVS have been reported by Munemoto [14], Inagaki [15] and MacDonald [16] and were related to post hyperventilation apnea (PHA). In most cases, patients spontaneously recover from PHA within one or two minutes without any clinical problems, but cases with prolonged PHA was reported as an example of near fatal instance of PHA [16].…”

Section: Discussionmentioning

confidence: 86%

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Spasmophilia in the Cardiological Outpatient Department: A Retrospective Study of 228 Sub-saharan Africans over 5 Years

Marie¹,

Saidou²,

Diack³

et al. 2017

J Thrombo Cir

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Background: Spasmophilia also called latent tetany is a disorder with a very heterogeneous clinical manifestation which affects particulary young women. Chest pain, constriction of the throat and palpitations are symptoms common to spasmophilia and ischaemic heart disease (IHD). The objective of this work was to assess the incidence and to study the epidemiological, clinical features of spasmophilia in patients with symptoms of ischaemic heart disease.

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Section: Discussionmentioning

confidence: 86%

“…In most cases, patients spontaneously recover from PHA within one or two minutes without any clinical problems, but cases with prolonged PHA was reported as an example of near fatal instance of PHA [16]. PHA has been reported to be due to a decreased PaCO 2 .…”

Section: Discussionmentioning

confidence: 99%

Spasmophilia in the Cardiological Outpatient Department: A Retrospective Study of 228 Sub-saharan Africans over 5 Years

Marie¹,

Saidou²,

Diack³

et al. 2017

J Thrombo Cir

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“…PHA and BHS differ in the age of onset. MacDonald’s case was a 14-year-old girl [12]. The mechanism of BHS is associated with various physiological (dysregulation of vagal nerve, anemia, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have reported PHA related to HVS. To our knowledge, only Inagaki [11], MacDonald [12], and Chin [13] reported PHA with hypoxemia related to HVS. However, aside from MacDonald’s case, there are few previous case reports of HVS patients who were rescued from PHA after having long term PHA accompanied by cyanosis, hypoxemia, and loss of consciousness.…”

Section: Introductionmentioning

confidence: 99%

Prolonged post-hyperventilation apnea in two young adults with hyperventilation syndrome

Munemoto

Masuda²,

Nagai³

et al. 2013

BioPsychoSocial Med

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BackgroundThe prognosis of hyperventilation syndrome (HVS) is generally good. However, it is important to proceed with care when treating HVS because cases of death following hyperventilation have been reported. This paper was done to demonstrate the clinical risk of post-hyperventilation apnea (PHA) in patients with HVS.Case presentationWe treated two patients with HVS who suffered from PHA. The first, a 21-year-old woman, had a maximum duration of PHA of about 3.5 minutes and an oxygen saturation (SpO2) level of 60%. The second patient, a 22-year-old woman, had a maximum duration of PHA of about 3 minutes and an SpO2 level of 66%. Both patients had loss of consciousness and cyanosis. Because there is no widely accepted regimen for treating patients with prolonged PHA related to HVS, we administered artificial ventilation to both patients using a bag mask and both recovered without any after effects.ConclusionThese cases show that some patients with HVS develop prolonged PHA or severe hypoxia, which has been shown to lead to death in some cases. Proper treatment must be given to patients with HVS who develop PHA to protect against this possibility. If prolonged PHA or severe hypoxemia arises, respiratory assistance using a bag mask must be done immediately.

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“…Hypoxemia fol lowing VHV has been occasionally reported in several laboratories [5][6][7], in a case report [8] and in a postopera tive stage [9]. However, it has not been well documented in the clinical VHV test.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Severity of Hypoxemia following Clinical Voluntary Hyperventilation

Chin

Ohi²,

Fujita³

et al. 1996

Respiration

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The voluntary hyperventilation (VHV) test is used in many clinical examinations. However, arterial hypoxemia following a clinical VHV test is not a well-studied phenomenon. We analyzed the arterial blood gases (ABGs) of 61 patients during a VHV test. The ABG were taken prior to (PaO₂-Prior), immediately following (PaO₂ Immediate), and 5 min after (PaO₂-After) the VHV test. The patients’ average PaO₂ rose significantly (p < 0.0001) from the PaO₂-Prior (88 ± 8 mm Hg; mean ± SD) to the PaO₂-lmmediate (118 ± 13 mm Hg) and then dropped significantly (p < 0.0001) to the PaO₂-After (74 ± 16 mm Hg). Two of the 20 patients who experienced an angina pectoris attack (AP(+)) following the VHV test showed severe arterial hypoxemia (PaO₂-After < 60 mm Hg), whereas 9 of the 41 patients who did not experience an angina pectoris attack (AP(-)) showed a PaO₂-After < 60 mm Hg. The PaO₂-After did not correlate with the PaO₂-Prior. The decrease in the PaO₂-Prior to After did not correlate significantly with the left ventricular ejection fraction rate (n = 58, r = 0.18, not significant). However, the decrease in the PaO₂-Prior to After correlated well with the degree of recovery of the PaO₂ following the VHV test (r = -0.69, p < 0.0001). The age, gender ratio, changes in arterial blood gases, number of patients who experienced PaO₂ After < 60 mm Hg, and left-ventricular ejection fraction rate were not significantly different between the AP(-) and AP(+) groups. Posthyperventilation hypoxemia developed frequently following the VHV test during coronary angiography. Although this arterial hypoxemia was not directly correlated with the occurrence of AP attacks following VHV in this study, continuous SaO₂ monitoring is recommended whenever a VHV test is used as a diagnostic technique to avoid the potentially deleterious effects of arterial hypoxemia.

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Posthyperventilation Apnea Associated with Severe Hypoxemia

Cited by 15 publications

References 14 publications

Spasmophilia in the Cardiological Outpatient Department: A Retrospective Study of 228 Sub-saharan Africans over 5 Years

Spasmophilia in the Cardiological Outpatient Department: A Retrospective Study of 228 Sub-saharan Africans over 5 Years

Prolonged post-hyperventilation apnea in two young adults with hyperventilation syndrome

Prevalence of Severity of Hypoxemia following Clinical Voluntary Hyperventilation

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