RT Journal Article
SR Electronic
T1 Unusual case of central alveolar hypoventilation
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 305
OP 310
DO 10.15537/smj.2018.3.210803
VO 39
IS 3
A1 AlOtair, Hadil AK.
A1 Alzeer, Abdulaziz H.
A1 Abdou, Mohammed A.
A1 Qasrawi, Shaden O.
YR 2018
UL http://smj.org.sa/content/39/3/305.abstract
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.