Effects of Ventilation-Perfusion Mismatch on Severity of Obstructive Sleep Apnea: A Modeling Study

Khoo, Michael C. K.; Hu, Wen-Hsin; Amin, Raouf S.

doi:10.1109/embc44109.2020.9175297

Cited by 5 publications

(2 citation statements)

References 9 publications

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“…1 4 but here we found a relationship that applies for different subjects and not to the variations of ventilation for a given subject. Moreover, it is expected from the model of Khoo and colleagues 15 (eq. S1 in Supplementary Information online) that steady-state PG (PG0) decreases with increasing alveolar ventilation and shunt fraction.…”

Section: Discussionmentioning

confidence: 93%

Controller and loop gains are decreased by oropharyngeal obstruction in pediatric obstructive sleep apnea syndrome

Bokov

Boujemla

Matrot

et al. 2022

Preprint

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Instable ventilatory control is an endotypic trait of obstructive sleep apnea syndrome (OSAS). The study aimed to evaluate the relationships between the anatomical compromise of the upper (oro- and naso-pharynx) and lower airways and ventilatory control (measured by chemical loop gain) in otherwise healthy children suffering from moderate to severe OSAS (apnea hypopnea index ≥ 5/hour). The children underwent ear, nose and throat examination, measurement of impedance of the respiratory system that allowed characterizing peripheral lung mechanics using the extended Resistance-Inertance-Compliance model. Physiologically constrained analytical model based on tidal breathing analysis allowed the computation of steady-state plant gain (PG0), steady-state controller gain (CG0) and steady-state loop gain (LG0). Medium-frequency components of feedback control system were then deduced. Fifty children (median age 11.2 years, 17 females) were enrolled. Oropharyngeal obstruction was associated with decreased CG0 (0.6 [0.2; 1.0] vs 1.5 [0.5; 6.6] L.s− 1.mmHg− 1, p = 0.038) and LG0 (0.4 [0.2; 1.1] vs 1.2 [0.4; 9.3], p = 0.027), while nasal obstruction did not modify ventilatory control parameters. In a multivariate analysis Medium-Frequency PG was negatively related to minute ventilation and respiratory system compliance. Both upper (tonsil hypertrophy) and lower (compliance of respiratory system) airways are linked to ventilatory control in children with moderate to severe OSAS.

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Section: Discussionmentioning

confidence: 93%

Controller and loop gains are decreased by oropharyngeal obstruction in pediatric obstructive sleep apnea syndrome

Bokov

Boujemla

Matrot

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…PG may be abnormally elevated as a result of abnormal lung volumes, reduced ability to eliminate CO 2 adequately such as in ventilation/perfusion mismatch and decreased pulmonary blood flow. A recently published mathematical model by Khoo et al 10 . suggests that ventilation/perfusion mismatch may contribute to an increase in severity of OSA by increasing PG, which amplifies the fluctuations in blood gases during obstructive episodes, potentially triggering subsequent arousal and propagating the instability.…”

mentioning

confidence: 99%