Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation
Sleep brings major challenges for the control of ventilation in humans, particularly the regulation of arterial carbon dioxide pressure (PaCO2). In patients with COPD, chronic hypercapnia is associated with increased mortality. Therefore, nocturnal high-level noninvasive positive-pressure ventilatio...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2022-09-01
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| Series: | European Respiratory Review |
| Online Access: | http://err.ersjournals.com/content/31/165/220069.full |
| _version_ | 1798000223457378304 |
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| author | Alexandra McCartney Devin Phillips Matthew James Olivia Chan J. Alberto Neder Juan P. de-Torres Nicolle J. Domnik Sophie J. Crinion |
| author_facet | Alexandra McCartney Devin Phillips Matthew James Olivia Chan J. Alberto Neder Juan P. de-Torres Nicolle J. Domnik Sophie J. Crinion |
| author_sort | Alexandra McCartney |
| collection | DOAJ |
| description | Sleep brings major challenges for the control of ventilation in humans, particularly the regulation of arterial carbon dioxide pressure (PaCO2). In patients with COPD, chronic hypercapnia is associated with increased mortality. Therefore, nocturnal high-level noninvasive positive-pressure ventilation (NIV) is recommended with the intention to reduce PaCO2 down to normocapnia. However, the long-term physiological consequences of PaCO2 “correction” on the mechanics of breathing, gas exchange efficiency and resulting symptoms (i.e. dyspnoea) remain poorly understood. Investigating the influence of sleep on the neural drive to breathe and its translation to the mechanical act of breathing is of foremost relevance to create a solid rationale for the use of nocturnal NIV. In this review, we critically discuss the mechanisms by which sleep influences ventilatory neural drive and mechanical consequences in healthy subjects and hypercapnic patients with advanced COPD. We then discuss the available literature on the effects of nocturnal NIV on ventilatory neural drive and respiratory mechanics, highlighting open avenues for further investigation. |
| first_indexed | 2024-04-11T11:16:46Z |
| format | Article |
| id | doaj.art-fa04719825804476bcd9f76cbac9d2ff |
| institution | Directory Open Access Journal |
| issn | 0905-9180 1600-0617 |
| language | English |
| last_indexed | 2024-04-11T11:16:46Z |
| publishDate | 2022-09-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | European Respiratory Review |
| spelling | doaj.art-fa04719825804476bcd9f76cbac9d2ff2022-12-22T04:27:11ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172022-09-013116510.1183/16000617.0069-20220069-2022Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilationAlexandra McCartney0Devin Phillips1Matthew James2Olivia Chan3J. Alberto Neder4Juan P. de-Torres5Nicolle J. Domnik6Sophie J. Crinion7 Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Dept of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada Dept of Medicine, Queen's University, Kingston, ON, Canada Sleep brings major challenges for the control of ventilation in humans, particularly the regulation of arterial carbon dioxide pressure (PaCO2). In patients with COPD, chronic hypercapnia is associated with increased mortality. Therefore, nocturnal high-level noninvasive positive-pressure ventilation (NIV) is recommended with the intention to reduce PaCO2 down to normocapnia. However, the long-term physiological consequences of PaCO2 “correction” on the mechanics of breathing, gas exchange efficiency and resulting symptoms (i.e. dyspnoea) remain poorly understood. Investigating the influence of sleep on the neural drive to breathe and its translation to the mechanical act of breathing is of foremost relevance to create a solid rationale for the use of nocturnal NIV. In this review, we critically discuss the mechanisms by which sleep influences ventilatory neural drive and mechanical consequences in healthy subjects and hypercapnic patients with advanced COPD. We then discuss the available literature on the effects of nocturnal NIV on ventilatory neural drive and respiratory mechanics, highlighting open avenues for further investigation.http://err.ersjournals.com/content/31/165/220069.full |
| spellingShingle | Alexandra McCartney Devin Phillips Matthew James Olivia Chan J. Alberto Neder Juan P. de-Torres Nicolle J. Domnik Sophie J. Crinion Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation European Respiratory Review |
| title | Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation |
| title_full | Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation |
| title_fullStr | Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation |
| title_full_unstemmed | Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation |
| title_short | Ventilatory neural drive in chronically hypercapnic patients with COPD: effects of sleep and nocturnal noninvasive ventilation |
| title_sort | ventilatory neural drive in chronically hypercapnic patients with copd effects of sleep and nocturnal noninvasive ventilation |
| url | http://err.ersjournals.com/content/31/165/220069.full |
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