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T Podszus

Publications and source records attributed to T Podszus.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Sleep apnea].

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Humans↗
PubMed1989

Central alveolar hypoventilation and sleep. Treatment by intermittent positive-pressure ventilation through nasal mask in an adult.

Idiopathic central alveolar hypoventilation, uncommonly seen in middle-aged adults, has often been treated by tracheostomy and assisted ventilation during sleep or by implantation of a diaphragmatic pacemaker with or without tracheostomy. We report the successful treatment of a middle-aged man by the easy application of intermittent positive-pressure ventilation through a nose mask.

Humans↗
PubMed1989

[Does determination of atrial natriuretic factor have significance in the assessment of cardiac stress in apnea in sleep apnea patients?].

It has long been known that the heart is involved volume regulation. This fact took on new importance when, in 1981, de Bold discovered the existence of ANF. Apnea-associated cardiovascular changes make the treatment of apnea necessary to prevent the occurrence of cardiovascular sequelae. What is needed, however, is a parameter which, non-invasively, reflects both the cardiac loading during apnea and effects of treatment. Krieger succeeded in demonstrating that the commonly observed nycturia regresses under nasal cPAP therapy. This prompted us to consider whether the ANF factor might not be involved. In an attempt to find an answer, we have, up to now, investigated six patients prior to and during nCPAP therapy. On the basis of the results we obtained, the following conclusions may be drawn: 1. During apnea, the patients show sometimes dramatic increases in ANF plasma levels. 2. Under nasal CPAP treatment, these elevated levels decrease again, in some cases by as much as 50%. 3. The ANF plasma level correlates with pulmonary arterial pressure. This suggests to us that ANF determination is of importance for the assessment of cardiac loading during apnea, and represents a parameter that reflects the effects of therapy.

Atrial Natriuretic Factor↗
PubMed1989

[Treatment of sleep apnea].

Sleep-related breathing disorders often lead to cardio-pulmonary and cardiovascular complications as well as to cardiac failure. It is thus necessary to carry out a detailed medical diagnostic work-up to assess the cardiac risk before initiating therapy. Basic requirements for successful therapy are preventive measures. Weight reduction for the usually overweight patients, avoidance of alcohol, sedatives and tranquilizers, and adequate sleep hygiene. Before a vacation at high altitudes, individual advice is needed. Medical treatment includes the prescription of respiration stimulants in certain cases as also--after careful estimation of the risks--prescription of tricyclic antidepressants. Today, the application of calcium-channel blockers and theophylline seems to be most successful. In an examination of our own involving 20 patients we found a significant reduction in the apnoea index due to treatment with euphyllong. In cases of pronounced findings and corresponding symptoms the use of mechanical measures, especially of nasal CPAP therapy can be recommended in more than 80% of patients. Those who cannot be adequately treated by the methods mentioned above, must be provided with a tracheostomy. This drastic form of therapy should only be considered after a thorough diagnostic evaluation and exhaustive use of all other methods. At present, oxygen therapy is still under discussion in the literature and can be recommended only in cases of an "overlap" syndrome.

Combined Modality Therapy↗
PubMed1988

[Cardiovascular diseases in nocturnal disorders of respiratory regulation].

Sleep related disorders of respiratory regulation can result, through various mechanisms, in impairment of the hemodynamics of the heart and the systemic and pulmonary circulations. The group of patients with sleep apnea has been most thoroughly investigated thus far. The patients frequently develop essential and/or pulmonary hypertension. In sleep all forms of cardiac arrhythmia may occur, and thus the patients are at high risk for nocturnal sudden cardiac death. Responsibility for most hemodynamic alterations is attributed to apnea-induced hypoxia and hypercapnia and the intrathoracic pressure fluctuations observed in obstructive apnea. However, we are still short of detailed knowledge regarding the individual pathologic mechanisms. The hemodynamic changes observed in patients with sleep related disorders of respiratory regulation lead in the long run to cardiac failure. Early diagnosis and care of these patients is therefore urgently necessary to render timely therapeutic action possible.

Arrhythmias, Cardiac↗
PubMed1986

Sleep apnea and pulmonary hypertension.

The pulmonary artery pressure values of 65 patients with sleep apnea syndrome were measured at rest and during ergometer exercise up to 100 W. Pulmonary hypertension at rest was found in 13, and during exercise in 31 more patients. Only 8 patients with pathological pressure findings suffered from pulmonary hypertension in combination with a pulmonary or cardiac disease. In the other 36 patients, no indication of a primary cause of pulmonary hypertension apart from sleep apnea syndrome could be found. Out of the 65 patients, 11 with a finding of more than 20 apnea episodes per hour's sleep underwent polysomnographic recordings in the sleep laboratory. The hemodynamic parameters were continuously measured. All 11 patients had a finding of severe sleep apnea with more than 300 apnea episodes during the night of recording. In 6 patients, the appearance of apnea episodes was accompanied by only moderate changes in pulmonary artery pressure. In 5 patients, there were critical increases in pulmonary artery pressure, which went along with increases in cardiac output and in pulmonary capillary wedge pressure. Increases in pulmonary vascular resistance were established in 3 out of these 5 patients, and a slight decrease in 2. The mechanism of hypoxic vasoconstriction of the pulmonary arteries may account for the pressure increases in 3 of our patients, but fails to explain the findings in the other 2 patients. Nocturnal changes in pulmonary artery pressure in patients with sleep apnea may therefore have different causes. Pulmonary hypertension constitutes a severe complication in patients with sleep apnea.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗