関: respiratory failure、respiratory insufficiency、ventilatory depression

WordNet

a concavity in a surface produced by pressing; "he left the impression of his fingers in the soft mud" (同)impression, imprint
a long-term economic state characterized by unemployment and low prices and low levels of trade and investment (同)slump, economic crisis
a mental state characterized by a pessimistic sense of inadequacy and a despondent lack of activity
angular distance below the horizon (especially of a celestial object)
pushing down; "depression of the space bar on the typewriter"
sad feelings of gloom and inadequacy
pertaining to respiration; "respiratory assistance"
a breathing device for administering long-term artificial respiration (同)inhalator
a period during the 1930s when there was a worldwide economic depression and mass unemployment (同)Great_Depression

PrepTutorEJDIC

〈C〉『くぼ地』,くぼみ / 〈U〉〈C〉『意気消沈』,憂うつ;うつ病 / 〈C〉『不景気』,不況 / 〈U〉押し下げること,降下,低下
呼吸の,呼吸作用の,呼吸のための
《米》人工呼吸装置 / (一般に)マスク;防毒マスク

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/01/13 01:13:37」(JST)

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Not to be confused with hypopnea or hyperventilation.

In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate^[1] (hypo means "below") to perform needed gas exchange. By definition it causes an increased concentration of carbon dioxide (hypercapnia) and respiratory acidosis.

Causes

It can be caused by medical conditions, such as stroke affecting the brainstem, by holding one's breath, or by drugs, typically when taken in overdose. Hypocapnia also stimulates hypoventilation.

Effects

As a side effect of medicines or recreational drugs, hypoventilation may become potentially life-threatening. Many different CNS depressant drugs such as alcohol, benzodiazepines, barbiturates, GHB, sedatives and opiates produce respiratory depression when taken in large or excessive doses; however this is most commonly seen as a cause of death with opiates or opioids, particularly when they are combined with sedatives such as alcohol or benzodiazepines. Strong opiates, (fentanyl, heroin, morphine, etc.), barbiturates, and the benzodiazepine, temazepam, are notorious for producing this effect; in an overdose, an individual may cease breathing entirely (go into respiratory arrest) which is rapidly fatal without treatment.

Treatment

Respiratory stimulants such as nikethamide were traditionally used to counteract respiratory depression from CNS depressant overdose, but were of only limited effectiveness. A new respiratory stimulant drug BIMU8 is currently being investigated which seems to be significantly more effective and may be useful for counteracting the respiratory depression produced by opiates and similar drugs without offsetting their therapeutic effects.

If the respiratory depression is from opioid overdose, then the overdose itself is usually treated with an inverse agonist, most likely naloxone, which will itself almost instantaneously stop the respiratory depression if caused by an opioid (and also, depending on the dose, plunge the patient into precipitated withdrawal).

Associated conditions

Disorders referred to as "Congenital Central Hypoventilation Syndrome" or "CCHS" and "Rapid-Onset Obesity, Hypothalamic Dysfunction, Hypoventilation, with Autonomic Dysregulation" or ROHHAD are recognized. CCHS condition may be a significant factor in some cases of sudden infant death syndrome or SIDS, often termed "cot death" or "crib death."

The opposite condition is hyperventilation (too much ventilation), resulting in low carbon dioxide levels (hypocapnia), rather than hypercapnia.

References

^ "hypoventilation" at Dorland's Medical Dictionary

UpToDate Contents

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1. Congenital central hypoventilation syndrome and other causes of sleep-related hypoventilation in children
2. 換気調節障害 disorders of ventilatory control
3. 肥満低換気症候群の臨床症状および診断 clinical manifestations and diagnosis of obesity hypoventilation syndrome
4. 肥満低換気症候群の治療 treatment of the obesity hypoventilation syndrome
5. 高二酸化炭素血症の発症機序、原因、および影響 mechanisms causes and effects of hypercapnia

English Journal

The effect of two different doses of remifentanil on postoperative pain and opioid consumption after cardiac surgery - a randomized controlled trial.

Florkiewicz P1, Musialowicz T1, Pitkänen O1, Lahtinen P1.
Acta anaesthesiologica Scandinavica.Acta Anaesthesiol Scand.2015 Sep;59(8):999-1008. doi: 10.1111/aas.12536. Epub 2015 Apr 21.
BACKGROUND: Remifentanil, an ultra-short-acting opioid, provides intensive analgesia without prolonged respiratory depression and is widely used in cardiac surgery. Diminished dosing may also offer stable hemodynamics, even during sternotomy and sternal retraction. However, increased postoperative p
PMID 25900227

Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis.

Sutterland AL1, Fond G2,3, Kuin A1, Koeter MW1, Lutter R4, van Gool T5, Yolken R6, Szoke A2,3, Leboyer M2,3, de Haan L1.
Acta psychiatrica Scandinavica.Acta Psychiatr Scand.2015 Sep;132(3):161-79. doi: 10.1111/acps.12423. Epub 2015 Apr 15.
OBJECTIVE: To perform a meta-analysis on studies reporting prevalence of Toxoplasma gondii (T. gondii) infection in any psychiatric disorder compared with healthy controls. Our secondary objective was to analyze factors possibly moderating heterogeneity.METHOD: A systematic search was performed to
PMID 25877655

Persistent critical illness characterised by Australian and New Zealand ICU clinicians.

Iwashyna TJ1, Hodgson CL2, Pilcher D2, Bailey M2, Bellomo R2.
Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine.Crit Care Resusc.2015 Sep;17(3):153-8.
OBJECTIVE: To identify the characteristics of patients with "persistent critical illness" (PerCI), as perceived by Australian and New Zealand intensive care unit clinicians. Patients with PerCI were defined as those whose reason for being in the ICU was now more related to their ongoing critical ill
PMID 26282252

Japanese Journal

MACに必要なモニターと具体的なMAC法 (特集日本のMAC(monitored anesthesia care)をどうするか?)

鈴木利保
麻酔 64(3), 243-254, 2015-03
NAID 40020380725

Effect of midazolam and butorphanol premedication on inhalant isoflurane anesthesia in mice

, , [他], ,
Experimental Animals 64(2), 139-145, 2015
… However, isoflurane mediates respiratory depression and adverse clinical reactions during induction. … Core body temperature, heart rate, respiratory rate, and oxygen saturation (SPO2) were assessed before and for 1 h after induction. … Furthermore, isoflurane anesthesia with MB premedication caused increase of respiratory rates compared to isoflurane monoanesthesia. …
NAID 130005069858

The pharmacological effects of the anesthetic alfaxalone after intramuscular administration to dogs

, , , , , , , ,
Journal of Veterinary Medical Science 77(3), 289-296, 2015
… Anesthetic effect was subjectively evaluated by using an ordinal scoring system to determine the degree of neuro-depression and the quality of anesthetic induction and recovery from anesthesia. … Alfaxalone administered IM produced dose-dependent neuro-depression and lateral recumbency (i.e., 36 ± 28 min, 87 ± 26 min and 115 ± 29 min after the IM5, IM7.5 and IM10 treatments, respectively). …
NAID 130005060985