Central Alveolar Hypoventilation

A 46-year-old truck driver presented with hypoxia, hypercapnia, pulmonary hypertension, cor pulmonale, and anasarca due to central alveolar hypoventilation. After his cardiovascular status was compensated clinically, functional responses to exercise, sleep, administration of a respiratory stimulant, and voluntary hyperventilation were measured. Hypoxemia and hypercapnia were exaggerated during sleep, were less pronounced during moderate exercise, and were not affected by administration of ethamivan. It was concluded that appropriate therapy should include repeated episodes of light to moderate physical activity during the day combined with attempts at stimulating respiratory function during sleep. Although a regimen combining these approaches was devised, the patient found it unacceptable, and it therefore was not successfully implemented. His course gradually deteriorated, and he died at age 50 of apparent cardiovascular complications.