PT  - JOURNAL ARTICLE
AU  - Hadil AK. AlOtair
AU  - Abdulaziz H. Alzeer
AU  - Mohammed A. Abdou
AU  - Shaden O. Qasrawi
TI  - Unusual case of central alveolar hypoventilation
AID  - 10.15537/smj.2018.3.210803
DP  - 2018 Mar 01
TA  - Saudi Medical Journal
PG  - 305--310
VI  - 39
IP  - 3
4099  - http://smj.org.sa/content/39/3/305.short
4100  - http://smj.org.sa/content/39/3/305.full
SO  - Saudi Med J2018 Mar 01; 39
AB  - Central alveolar hypoventilation is rarely encountered. This case report describes a young woman who was recently diagnosed with hypertension and ischemic heart disease. She presented to the emergency room with hypercapnic respiratory failure, for which she was mechanically ventilated. This was preceded by an acute upper respiratory tract infection. She was initially suspected to have Guillain-Barré syndrome, but further investigations ruled out neuromuscular or autoimmune disorders. Sleep-related hypoventilation was suspected after she experienced recurrent apneas at night that resulted in re-intubation. Polysomnographic studies confirmed episodes of central apnea and hypopnea during sleep, with significant carbon dioxide retention and oxygen desaturations. She required nocturnal ventilation via a tracheostomy tube until a diaphragmatic pacer could be placed. Using bi-level positive airway pressure and average volume-assured pressure support together with the diaphragmatic pacer, adequate ventilation during sleep was achieved.