Ventilatory management and weaning in a patient with central hypoventilation caused by a brainstem cavernoma.
We describe a patient with a brainstem cavernoma who was dependent on hypoxic respiratory drive initially. After excision of the lesion, the patient developed severe hypoventilation unresponsive to both hypoxia and hypercapnia. Weaning from mechanical ventilation could be achieved through central respiratory stimulation by acetazolamide. Problems associated with respiratory management of central hypoventilation due to a brainstem lesion are described.
Rao
G S U
GS
Department of Neuroanesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India. gsuma@nimhans.kar.nic.in
Ramesh
V J
VJ
Lalla
R K
RK
D000086:Acetazolamide / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001784:Blood Gas Analysis / Q000379:methods; D020295:Brain Stem Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000601:surgery; D006801:Humans; D007040:Hypoventilation / Q000209:etiology* / Q000628:therapy*; D008875:Middle Aged; D012121:Respiration, Artificial / Q000379:methods*; D014139:Tracheostomy / Q000379:methods; D015300:Ventilator Weaning / Q000379:methods*
D000927:Anticonvulsants; D000086:Acetazolamide