Division of Pediatric Pulmonology, Emory University, Children's Healthcare of Atlanta, 1400 Tullie Road Northeast, Atlanta, GA 30329, USA.
Division of Pediatric Pulmonology and Sleep Medicine, Children's Hospital Los Angeles, Keck School of Medicine of the University of Southern California, 4650 Sunset Boulevard, MS #83, Los Angeles, CA 90027, USA.
Clin Chest Med. 2024 Sep;45(3):663-673. doi: 10.1016/j.ccm.2024.02.018.
Congenital disorders of ventilatory control typically manifest as central apneas, periodic breathing, and hypoventilation in the neonatal period, but some may present at a later age. Obstructive apneas may be the initial presentation, and some may have associated autonomic nervous system dysfunction. Individuals with these disorders can have absent or impaired ventilatory and arousal responses to hypoxemia and hypercapnia. This article discusses the presentation, pathophysiology, evaluation, and management of congenital central hypoventilation syndrome, rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation (ROHHAD) syndrome, Prader-Willi syndrome, and myelomeningocele.
先天性通气控制障碍通常表现为新生儿期的中枢性呼吸暂停、周期性呼吸和通气不足,但也有些可能在较晚年龄出现。阻塞性呼吸暂停可能是最初的表现,有些可能伴有自主神经系统功能障碍。这些疾病患者的低氧血症和高碳酸血症通气和觉醒反应可能缺失或受损。本文讨论了先天性中枢性通气不足综合征、肥胖-下丘脑功能障碍-通气不足-自主神经功能紊乱(ROHHAD)综合征、普拉德-威利综合征和脊髓脊膜膨出的表现、病理生理学、评估和管理。