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Ventilatory and Orthostatic Challenges Reveal Biomarkers for Neurocognition in Children and Young Adults With Congenital Central Hypoventilation Syndrome.
Chest
June 2023
Division of Autonomic Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Stanley Manne Children's Research Institute, Chicago, IL.
Background: Children and young adults with congenital central hypoventilation syndrome (CCHS) are at risk of cognitive deficits. They experience autonomic dysfunction and chemoreceptor insensitivity measured during ventilatory and orthostatic challenges, but relationships between these features are undefined.
Research Question: Can a biomarker be identified from physiologic responses to ventilatory and orthostatic challenges that is related to neurocognitive outcomes in CCHS?
Study Design And Methods: This retrospective study included 25 children and young adults with CCHS tested over an inpatient stay.
Opioid overdose detection using smartphones.
Sci Transl Med
January 2019
Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA 98195, USA.
Early detection and rapid intervention can prevent death from opioid overdose. At high doses, opioids (particularly fentanyl) can cause rapid cessation of breathing (apnea), hypoxemic/hypercarbic respiratory failure, and death, the physiologic sequence by which people commonly succumb from unintentional opioid overdose. We present algorithms that run on smartphones and unobtrusively detect opioid overdose events and their precursors.
View Article and Find Full Text PDFVenovenous Extracorporeal Membrane Oxygenation to Prolong Pregnancy: A Case Report.
A A Pract
May 2018
From the Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland.
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration.
View Article and Find Full Text PDFPartial neuromuscular block impairs arytenoid abduction during hypercarbic challenge in anesthetized dogs.
Vet Anaesth Analg
September 2017
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA. Electronic address:
Objective: To evaluate the effect of two levels of partial neuromuscular block (NMB) on arytenoid abduction, tidal volume (V) and peak inspiratory flow (PIF) in response to a hypercarbic challenge in anesthetized dogs.
Study Design: Prospective laboratory study.
Animals: Eleven healthy male Beagle dogs aged 3-5 years.
Inner ear lesion and the differential roles of hypoxia and hypercarbia in triggering active movements: Potential implication for the Sudden Infant Death Syndrome.
Neuroscience
November 2016
Department of Anesthesia, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, United States; Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 Ninth Avenue, Seattle, WA 98101, United States; Department of Anesthesia, University of Washington, Seattle, WA, United States. Electronic address:
Infants that succumb to Sudden Infant Death Syndrome (SIDS) have been identified with inner ear dysfunction (IED) at birth and on autopsy. We previously investigated whether IED could play a mechanistic role in SIDS. We discovered that animals with IED displayed significant suppression of movement arousal to a hypoxic-hypercarbic gas mixture under light anesthesia.
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