Though the prevalence of CSA is lower than OSA, both conditions often coexist, and patients can exhibit features of both states. Upper airway narrowing consistently occurs at the retropalatal level during induced hypocapnic central apnea (video 1) and induced central hypopnea. Although there is a lack of effort during central events, it has been found that the upper airway narrows or nearly collapses during these events.
CSA manifests as a cyclical phenomenon/pattern during sleep periods of apnea or hypopnea alternating with hyperpnea. In general, CSA represents an array of sleep-disordered breathing (SDB) conditions due to the brief absence of ventilatory output during sleep. Expectant course, e.g., anticipated patient decline or impending transfer.Ĭentral sleep apnea (CSA) is characterized by transient diminution or cessation of the respiratory rhythm generator located within the pontomedullary region of the brain. Cardiovascular distress whereby mechanical ventilation can offload the energy requirements of breathing. Hypoxemic respiratory failure due to a failure of oxygenation. Hypercapnic respiratory failure due to a decrease in minute ventilation. Airway protection in a patient who is obtunded or has a dynamic airway, e.g., from trauma or oropharyngeal infection. The primary indications for mechanical ventilation are:: 1. It will review the basics of mechanical ventilation. The focus of this article will be on the management of the intubated patient in the first few hours of care on mechanical ventilation. Additionally, providers must also understand how applying mechanical ventilation affects patient physiology and response to disease states. Although mechanical ventilation can be a complex and seemingly elusive topic, expectations are that physicians and healthcare professionals who deal with critically ill patients have a basic familiarity with the management of a patient on a ventilator.
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