PT  - JOURNAL ARTICLE
AU  - Gozal, D
AU  - Torres, JE
AU  - Menendez, AA
TI  - Longitudinal assessment of hypercapnic ventilatory drive after tracheotomy in a patient with the Prader-Willi syndrome
DP  - 1996 Jul 01
TA  - European Respiratory Journal
PG  - 1565--1568
VI  - 9
IP  - 7
4099  - http://erj.ersjournals.com/content/9/7/1565.short
4100  - http://erj.ersjournals.com/content/9/7/1565.full
SO  - Eur Respir J1996 Jul 01; 9
AB  - The clinical course and changes in hypercapnic ventilatory drive over time were serially assessed before and after tracheostomy placement in a 14 year old, morbidly obese female patient with Prader-Willi syndrome, severe obstructive sleep apnoea, and obesity-hypoventilation syndrome. A tracheostomy became necessary after supplemental oxygen and continuous positive airway pressure (CPAP) had failed to improve the severity of nocturnal hypoventilation. Continued improvement in the slope to rebreathing hyperoxic hypercapnia occurred from 2-10 weeks after tracheotomy in conjunction with night-time bilevel pressure ventilation, and remained unchanged thereafter. In contrast, increases in mean resting minute ventilation at an end-tidal carbon dioxide tension (PET,CO2) of 8 kPa (60 mmHg) were documented even after 30 weeks. This case study illustrates the time-frame of dynamic ventilatory changes occurring after removal of upper airway resistance and normalization of nocturnal alveolar ventilation.