Category Archives: Lung Transplantation

Reversal of Nocturnal Periodic Breathing: Discussion

In September 2000, the patient received a double-lung transplant (at the University Hospital of Homburg/Saar; Dr. Schafers). The postoperative clinical course was complicated by acute renal failure requiring intermittent hemodialysis and cytomegalovirus infection of the transplanted lungs, but finally the patient recovered. Four months later, polysomnography was again performed with the patient breathing room air and without any cardiac medications. At this time, blood gases … Continue reading

Reversal of Nocturnal Periodic Breathing: TST

Hypopnea was defined as a reduction in the respiratory amplitude of > 50% compared to the preceding signals. All apneas and hypopneas were required to have a duration of at least 10 s. The apnea-hypopnea index (AHI) was obtained by dividing the total number of these events through the total sleep time (TST). An AHI of > 10/h of sleep was considered to be diagnostic … Continue reading

Reversal of Nocturnal Periodic Breathing: Apnea

Next, spiral and high-resolution CT scans of the chest were performed, which excluded the presence of proximal pulmonary emboli or parenchymal lung disease. Ventilation-perfusion scans were without evidence for central or peripheral pulmonary embolism. Serologic testing for collagen vascular or autoimmune disease was negative. Finally, Swan-Ganz catheterization (Edwards Lifesciences, Irvine, CA) with pharmacologic testing was done, showing severe precapillary pulmonary hypertension with a concomitant reduction … Continue reading

Reversal of Nocturnal Periodic Breathing

We have recently reported that patients with advanced primary pulmonary hypertension (PPH) may have nocturnal periodic breathing (PB) closely resembling Cheyne-Stokes respiration (CSR) in congestive heart failure (CHF). Presumably, hemodynamic impairment with prolongation of circulation time of chemical stimuli of breathing plays an important role in the emergence of PB in PPH. Blood gas alterations, ie, hypoxemia and hypocap-nia, are also likely to contribute to … Continue reading