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Diamox bij centrale apnoe’s

Diamox bij centrale apnoe’s. A. Boreas 22-07-04. Diamox bij centrale apnoe’s. Pub med: 7 artikelen De Backer et al. Central apnoe index decreases after prolonged treatment with acetozolamide. Am J Respir Crit Care Med 1995 ; 151: 87-91.

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Diamox bij centrale apnoe’s

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  1. Diamox bij centrale apnoe’s A. Boreas 22-07-04

  2. Diamox bij centrale apnoe’s • Pub med: 7 artikelen • De Backer et al. Central apnoe index decreases after prolonged treatment with acetozolamide. Am J Respir Crit Care Med 1995; 151: 87-91. • Philippi et al. Acetozolamide treatment for infantile central sleep apnoe. J Child Neurol 2001; 16: 600- 602.

  3. Centrale apnoe • Centrale chemosensoren: neuronen in medulla oblongata (n. tractus solitarius en n. (retro)ambiguus): gevoelig voor verandering in pCO2 en zuurgraad. • PO2  vasodilatatie  PCO2 afvoer  PCO2   chemosensoren minder geprikkeld  AH centrum pons minder geprikkeld  ademhalingsfrequentie 

  4. De Backer et al. • 14 pten centraal apnoe syndroom, gem lft 48 jr. • Dag 1: LF, bloedgas. ‘s avonds start 250 mg diamox • Dag 2: co LF, bloedgas, polysomnografie • Maand 1: zonder en met daimox co LF, bloedgas en polysomnografie

  5. Resultaten

  6. Philippi et al. • 12 neonaten pc lft 40-44 wk, partus gem 35 wk (28- 41 wk) • Centrale apnoe index > 40, saturaties < 90 % • Dag 1: start diamox 7 mg/kg/dag • Dag 2: polysomnografie • Moment 3: na 6 wk daimox aanpassen dosis, polysomnografie • Moment 4: na 5 wk diamox stop, na 1 week polysomnografie

  7. Resultaten

  8. Werking diamox • Effectief ! • Locale metabole acidose thv chemoreceptoren? • Vasodilatatie arteriolen pia mater? • Perifere chemoreceptoren verminderd gevoelig voor PO2 veranderingen?

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