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ABSTRACT

INTRODUCTION. RESULTS. DISCUSSION. Increased Susceptibility to Central Apnea in Chronic Cervical Spinal Cord Injury during Sleep. Study Protocol. Recruitment: Chronic SCI (>6 Month), 18-89 yr and on Ventilation. A.G. Sankri-Tarbichi, A. Bascom, M.S. Badr

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ABSTRACT

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  1. INTRODUCTION RESULTS DISCUSSION Increased Susceptibility to Central Apnea in Chronic Cervical Spinal Cord Injury during Sleep Study Protocol Recruitment: Chronic SCI (>6 Month), 18-89 yr and on Ventilation A.G. Sankri-Tarbichi, A. Bascom, M.S. Badr John D. Dingell VA Medical Center, WSU Sleep Research Laboratory, Detroit, MI Screening PSG, Questionnaires, ASIA, Spirometry and muscle forces Apneic threshold measurement during NREM sleep ABSTRACT CO2 Administration Protocol Mechanical Ventilation Protocol A representative cervical SCI patient with Cheyne Stokes Respiration • Sleep disordered breathing (SDB) is highly prevalent in patients with spinal cord injury (SCI) and may depend on the level of injury. • The exact mechanism of SDB in SCI is not known. • Recent data in animal SCI models showed that cervical SCI predisposes to alterations in ventilatory motor output suggesting an important role for breathing instability in the development of SDB in SCI patients. Central SDB Non-central SDB Mechanical ventilation HYPOTHESIS Cervical SCI patients have narrower CO2 reserve than thoracic SCI, hence more susceptible to hypocapnic central apnea SUBJECTS & METHODS Are cervical SCI more susceptible to hypocapnic central apnea ? INTRODUCTION Representative polygraph shows CO2 reserve determination in cervical SCI with non central SDB Representative polygraph shows CO2 reserve determination in cervical SCI with central SDB CO2 reserve is decreased in Cervical SCI (*p=0.04) compared to Thoracic SCI. Cervical SCI are more susceptible to hypocapnic central apnea than Thoracic SCI. CO2 Administration • Apneic threshold protocol • Non-invasive ventilation (NIV) for 3 minutes to cause hypocapnia and induce central apnea during NREM sleep. • PETCO2-AT was defined as the measured end tidal CO2 (PETCO2) at which the central apnea occurred. • The CO2 reserve was defined as Δ PETCO2 between stable breathing and apnea. • Cervical SCI patients are more susceptible than thoracic SCI to develop central apnea due to increased chemosensitivity to hypocapnia. • Increased susceptibility to central apnea may explain the mechanism of sleep apnea in cervical SCI patients. • Funded by VHA Merit Award

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