Breath-holding test in evaluation of peripheral chemoreflex sensitivity in healthy subjects

Трембач, Н. В.; Zabolotskikh, I.B.

doi:10.1016/j.resp.2016.10.005

Cited by 28 publications

(39 citation statements)

References 20 publications

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“…We note, however, that breath‐hold duration has previously been linked with elevated chemosensitivity during wakefulness (Stanley et al . ; Trembach & Zabolotskikh, ). In 1975, Stanley and coworkers (Stanley et al .…”

Section: Discussionmentioning

confidence: 99%

“…However, the strong associations observed, by us and others (Stanley et al . ; Trembach & Zabolotskikh, ), indicate that variability in maximal breath‐hold duration generally reflects variability in loop gain more than it reflects variability in the “breaking‐point” (i.e. the change in chemical drive that triggers voluntary breath‐hold termination).…”

Section: Discussionmentioning

confidence: 99%

“…Previously, investigators have demonstrated that chemoreflex sensitivity (a key determinant of loop gain) during wakefulness – measured via CO 2 rebreathing (Stanley et al . ) or dynamic CO 2 administration (Trembach & Zabolotskikh, ) – can be estimated simply by measuring how long participants can voluntarily hold their breath for (“maximal breath‐hold duration”). Conceptually, during a breath‐hold, participants generate their own hypoxia–hypercapnia at a rate determined by the plant (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Breath‐holding as a means to estimate the loop gain contribution to obstructive sleep apnoea

Messineo

Taranto‐Montemurro

Azarbarzin

et al. 2018

The Journal of Physiology

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Increased "loop gain" of the ventilatory control system promotes obstructive sleep apnoea (OSA) in some patients and offers an avenue for more personalized treatment, yet diagnostic tools for directly measuring loop gain in the clinical setting are lacking. Here we test the hypothesis that elevated loop gain during sleep can be recognized using voluntary breath-hold manoeuvres during wakefulness. Twenty individuals (10 OSA, 10 controls) participated in a single overnight study with voluntary breath-holding manoeuvres performed during wakefulness. We assessed (1) maximal breath-hold duration, and (2) the ventilatory response to 20 s breath-holds. For comparison, gold standard loop gain values were obtained during non-rapid eye movement (non-REM) sleep using the ventilatory response to 20 s pulses of hypoxic-hypercapnic gas (6% CO -14% O , mimicking apnoea). Continuous positive airway pressure (CPAP) was used to maintain airway patency during sleep. Additional measurements included gold standard loop gain measurement during wakefulness and steady-state loop gain measurement during sleep using CPAP dial-ups. Higher loop gain during sleep was associated with (1) a shorter maximal breath-hold duration (r = 0.49, P < 0.001), and (2) a larger ventilatory response to 20 s breath-holds during wakefulness (second breath; r = 0.50, P < 0.001); together these factors combine to predict high loop gain (receiver operating characteristic area-under-curve: 92%). Gold standard loop gain values were remarkably similar during wake and non-REM sleep. The results show that elevated loop gain during sleep can be identified using simple breath-holding manoeuvres performed during wakefulness. This may have implications for personalizing OSA treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Breath‐holding as a means to estimate the loop gain contribution to obstructive sleep apnoea

Messineo

Taranto‐Montemurro

Azarbarzin

et al. 2018

The Journal of Physiology

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“…Recent studies have shown that the duration of a voluntary breath-holding during a Breath-Holding Test (BHT) indirectly reflects the sensitivity of peripheral chemoreflex to carbon dioxide in subjects without cardiac and respiratory diseases [ 14 ]. However, its reproducibility and relationship with SB-CO 2 test was not evaluated in patients with HF previously.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Breath-Holding Test in Assessment of Peripheral Chemoreflex Sensitivity in Patients with Chronic Heart Failure

Трембач

Zabolotskikh

2017

TORMJ

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Background:The sensitivity of peripheral chemoreflex is a marker of the severity of heart failure and the prognosis of the outcome in these patients. The assessment of chemosensitivity in these patients remains an actual problem.Objective:The aim of the study was to explore the relationship between a Breath-Holding Test (BHT) and single-breath carbon dioxide test and to evaluate the reliability of both tests in patients with Heart Failure (HF).Method:The study was performed in 43 patients with chronic heart failure. All subjects underwent BHT and single-breath carbon dioxide (CB-CO2), the evaluation of both tests was repeated a month later. Relationship of two test was evaluated by correlation analysis. Reliability was assessed with calculation of Standard Error of Measurement (SEM), Coefficient of Variation (CV) and Intraclass Correlation Coefficient (ICC).Results:The duration of the breath-holding was inversely correlated to the result of CB-CO2 test (r = -0.86 at first measurement and r = -0.79 after a month) The ICC was 0.87 (95%CI: 0.78–0.93) for SB-CO2 test and 0,93 (95%CI: 0.88–0.96) for BHT, the CV was 24% for SB-CO2 and 13% for BHT. SEM for SB-CO2 test was 0.04 L / min / mmHg and limits of variation was 0.11 L / min / mmHg; SEM for BHT was 3.6 sec and limits of variation was10 sec.Conclusion:Breath-holding test is a reliable and safe method for assessing the sensitivity of peripheral chemoreflex to carbon dioxide in patients with heart failure.

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“…Накануне операции в первой половине дня проводили определение чувствительности периферического хеморефлекса методом регистрации длительности произвольного порогового апноэ (ППА) [8]. В зависимости от длительности ППА пациенты обеих групп были разделены на подгруппы: пациенты с высокой чувствительностью периферического хеморефлекса -группа В (n=79); пациенты с оптимальной чувствительностью периферического хеморефлекса -группа Н (n=97).…”

Section: материалы и методыunclassified

The Influence of Peripheral Chemoreflex Sensitivity on the Critical Incidents Rate During Combined Anesthesia

Трембач¹

2018

Kuban. nauсh. med. vestnik

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Aim. The goal of the study was to assess the impact of peripheral chemoreflex sensitivity on the rate of critical incidents in extensive abdominal operations.Materials and methods. The study included 176 patients who underwent major abdominal surgery under combined anesthesia. On the eve of surgery, sensitivity of peripheral chemoreflex was determined in all subjects. Sex, age, initial physical status, cardiovascular risk were also registered. During anesthesia hemodynamic, respiratory and metabolic critical incidents were registered.Results. In total, 158 critical incidents were observed. They were significantly more common in patients with high sensitivity to peripheral chemoreflex (72% vs. 48%, p<0.05). The structure of critical incidents was dominated by hemodynamic, primarily hypotension, and its frequency was 2 times higher among patients with high sensitivity of peripheral chemoreflex.The logistic regression showed that factors associated with the risk of critical incidents are high sensitivity of peripheral chemoreflex, increased age, and initially high grade of ASA scale.Conclusion. Hemodynamic incidents are the most common in major abdominal surgery; risk factors for their development are high sensitivity of peripheral chemoreflex, increased age and deterioration of the initial physical status.

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Breath-holding test in evaluation of peripheral chemoreflex sensitivity in healthy subjects

Abstract: A breath-holding test after deep inspiration reflects the sensitivity of the peripheral chemoreflex as defined by the single-breath carbon dioxide test in healthy subjects.

Cited by 28 publications

References 20 publications

Breath‐holding as a means to estimate the loop gain contribution to obstructive sleep apnoea

Breath‐holding as a means to estimate the loop gain contribution to obstructive sleep apnoea

Evaluation of Breath-Holding Test in Assessment of Peripheral Chemoreflex Sensitivity in Patients with Chronic Heart Failure

The Influence of Peripheral Chemoreflex Sensitivity on the Critical Incidents Rate During Combined Anesthesia

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