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Sleep and Breathing

, Volume 17, Issue 2, pp 487–493 | Cite as

Dynamic CO2 inhalation: a novel treatment for CSR–CSA associated with CHF

  • Zhi Hui Wan
  • Fang Jing Wen
  • Ke HuEmail author
Review

Abstract

Background

Cheyne–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 PaCO2 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, CO2 oscillations seen in CSR–CSA have yet to be looked at as a specific therapeutic target by current treatments.

Discussion

Previous studies have shown that delivery of constant CO2 is efficacious in eliminating CSR–CSA by raising PaCO2, 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 CO2 inhalation therapy has not been recommended as a routine option for therapy. However, recent new studies into CO2 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 CO2 in the management of CSR–CSA in CHF patients.

Keywords

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

Notes

Acknowledgments

This work was supported by the Natural Science Foundation of China (grant numbers 81070065).

Conflict of interest

The authors have declared that there is no conflict of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Division of Respiratory DiseaseRenmin Hospital of Wuhan UniversityWuhanChina

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