title: Dynamic CO₂ inhalation: a novel treatment for CSR-CSA associated with CHF.
abstract: BACKGROUND
  Cheyne-Stokes respiration with central sleep apnea (CSR-CSA) is very common in patients with chronic congestive heart failure (CHF). A current concept of the key pathophysiological mechanism leading to CSR-CSA is a fluctuation of PaCO2 below and above the apneic threshold. A number of therapeutic approaches for CSR-CSA have been proposed-all with varying success, some of which include various modes of positive airway pressure among other strategies. However, CO2 oscillations seen in CSR-CSA have yet to be looked at as a specific therapeutic target by current treatments.
  
  
  CONCLUSIONS
  Previous studies have shown that delivery of constant CO2 is efficacious in eliminating CSR-CSA by raising PaCO2, but there are serious concerns about the potential side effects, such as unwanted elevations in ventilation, work of breathing, and sympathetic nerve activity (SNA), and consequently CO2 inhalation therapy has not been recommended as a routine option for therapy. However, recent new studies into CO2 inhalation therapy have been made that may reshape its role as therapeutic. In this review, we will focus on the recent developments of administration of dynamic CO2 in the management of CSR-CSA in CHF patients.
authors.affiliation: Division of Respiratory Disease, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan 430060, China.
authors.forename: Zhi Hui
authors.initials: ZH
authors.lastname: Wan
authors.forename: Fang Jing
authors.initials: FJ
authors.lastname: Wen
authors.forename: Ke
authors.initials: K
authors.lastname: Hu
mesh_terms: D000280:Administration, Inhalation; D000465:Algorithms; D002245:Carbon Dioxide / Q000502:physiology / Q000627:therapeutic use*; D002639:Cheyne-Stokes Respiration / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010102:Oxygen Inhalation Therapy; D017286:Polysomnography; D012137:Respiratory System / Q000503:physiopathology; D020182:Sleep Apnea, Central / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide