Arch Dis Child
Department of Paediatrics, Royal Shrewsbury Hospital, Mytton Oak Road, Shrewsbury, Shropshire SY3 5PH, UK.
Published: February 2013
Background: Hyperventilation is known to cause ST segment changes and QT variability in adults, but this has not been systematically studied in children.
Aim: To investigate the effect of hyperventilation on rate corrected QT interval (QTc) in children.
Methods And Results: 25 children (male=10) with a median age of 14 (range 8.3-17.6) years were asked to hyperventilate for 1 min before exercise testing using the modified Bruce protocol. Mean QTc at rest, after hyperventilation, at peak exercise and at 1 min of recovery was 425(±31), 460(±30), 446(±38) and 420(±32) ms, respectively. Mean increase (95% CI) in QTc after hyperventilation was 35(19 to 51) ms (p<0.001), while there was minimal difference between QT interval at rest and after hyperventilation (mean QT 352(±41) vs 357(±44) ms). In six children, there were abnormalities in T wave morphology following hyperventilation. The QTc increment following hyperventilation was more pronounced in children with resting QTc <440 ms (n=14, mean increment (95% CI): 55 (33 to 78) ms) compared to children with QTc ≥440 ms (n=11, mean increment (95% CI): 9 (-4 to 22) ms) (p=0.001). QTc prolongation following hyperventilation was seen in children with both low and intermediate probability of long QT syndrome (LQTS). Peak exercise and early recovery did not cause a statistically significant change in QTc in either of these groups.
Conclusions: Hyperventilation produces repolarisation abnormalities, including prolongation of QTc and T wave abnormalities in children with low probability of LQTS. The likely mechanism is delayed adaptation of QT interval with increased heart rate. Thus, a hyperventilation episode can be misdiagnosed as LQTS, especially in an emergency department.
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http://dx.doi.org/10.1136/archdischild-2012-302663 | DOI Listing |
Front Physiol
January 2025
Environmental Physiology Group, Department of Health Sciences, Mid Sweden University, Östersund, Sweden.
Background And Aim: Hyperventilation before breath-hold diving (freediving) is widely accepted as a risk factor for hypoxic syncope or blackout (BO), but there is no practical way to address it before dives. This study explores the feasibility of using a force sensor to predict end-tidal carbon dioxide ( CO) to assess hyperventilation in freedivers.
Methods And Results: Twenty-one freedivers volunteered to participate during two national competitions.
J Appl Physiol (1985)
January 2025
Centre for Heart, Lung and Vascular Health, University of British Columbia - Okanagan Campus, Kelowna, BC, Canada.
Serotonin (5-HT) is integral to signalling in areas of the brainstem controlling ventilation and is involved in central chemoreception. Selective serotonin reuptake inhibitors (SSRIs), used to effectively increase 5-HT concentrations, are commonly prescribed for depression. The effects of SSRIs on the control of breathing and the potential influence of cerebral blood flow (CBF) have not been directly assessed.
View Article and Find Full Text PDFPLoS One
January 2025
Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
Background: Aeromedical transfer of patients with ischemic stroke to access hyperacute stroke treatment is becoming increasingly common. Little is known about how rapid changes of altitude and atmospheric pressure can impact cerebral perfusion and ischemic burden. In patients with ischemic stroke, there is a theoretical possibility that this physiologic response of hypoxia-driven hyperventilation at higher altitude can lead to a relative drop in PaCO2.
View Article and Find Full Text PDFAnn Gen Psychiatry
January 2025
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-Ku, Kumamoto, 860-8556, Japan.
Background: Seizure threshold increases with age and the frequency of electroconvulsive therapy (ECT). Therefore, therapeutic seizures can be difficult to induce, even at maximum stimulus charge with available ECT devices. Such cases are known as difficult-to-induce-seizures electroconvulsive therapy cases (DECs).
View Article and Find Full Text PDFExp Physiol
January 2025
Université Clermont Auvergne, Clermont-Ferrand, France.
This systematic review summarizes the available evidence on respiratory muscle endurance training involving voluntary isocapnic hyperpnoea among patients with chronic diseases. It includes both randomized and non-randomized controlled trials implementing this exercise training modality performed either alone or in combination with other interventions. It was conducted using the following databases: PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), Embase, CINAHL, CENTRAL, Cochrane and ReeDOC.
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