Carotid Body Dysfunction

Epidemiology

  • May Play a Role in the Sudden Infant Death Syndrome (SIDS)

Etiology

  • Bilateral Carotid Endarterectomy (see Carotid Endarterectomy, Carotid Endarterectomy)
    • Epidemiology: xxx
    • Physiology: destruction of peripheral chemoreceptors with resulting decreased hypoxic ventilatory response and slight increase in the resting arterial pCO2
  • Carotid Body Resection (Glomectomy) (see Carotid Body Resection, Carotid Body Resection)
    • Epidemiology
    • Physiology
      • Depressed Hypoxic Ventilatory Response During Exercise
      • Minor Abnormalities in Carbon Dioxide Regulation During Exercise: however, the pt is typically eucapnic at rest

Physiology

  • Dysfunction of Carotid Body Chemoreceptors
    • Central Hypoventilation: resulting in hypercapnia and hypoxemia (and consequent hypoxic pulmonary vasoconstriction)
    • Decreased Ventilatory Response to Hypercapnia/Hypoxemia
      • Note: Approximately 70% of the Hypercapnic Ventilatory Drive is Normally Due to the Medullary Brainstem Receptors with the Remainder Being Due to Cerebral Cortex Input, Carotid Body Chemoreceptors, Lung Mechanoreceptors, and Cerebrospinal Fluid pH (Which is the Most Sensitive)

Diagnosis

Complete Blood Count (CBC) (see Complete Blood Count, Complete Blood Count)

Arterial Blood Gas (ABG) (see Arterial Blood Gas, Arterial Blood Gas)

Pulmonary Function Tests (PFT’s) (see Pulmonary Function Tests, Pulmonary Function Tests)

  • Spirometry, Lung Volumes, DLCO, and MIP/MEP: usually normal

Electromyogram (EMG)/Nerve Conduction Velocity (NCV (see Electromyogram-Nerve Conduction Velocity, Electromyogram-Nerve Conduction Velocity)

  • Normal

Clinical Manifestations

Hematologic Manifestations

Polycythemia (see Polycythemia, Polycythemia)

  • xxx

Pulmonary Manifestations

Acute Hypoventilation/Acute Respiratory Failure (see Acute Hypoventilation, Acute Hypoventilation)

Chronic Hypoventilation/Chronic Respiratory Failure (see Chronic Hypoventilation, Chronic Hypoventilation)

Pulmonary Hypertension (see Pulmonary Hypertension, Pulmonary Hypertension)

  • xxx

Sleep-Disordered Breathing

  • xxx

Treatment

  • xxx

References

  • Surgical treatment of asthma, chronic bronchitis and emphysema by bilateral carotid body resection. Respir Ther. 1975; 5:18
  • Bilateral carotid body resection for the relief of dyspnea in severe chronic obstructive pulmonary disease. Physiologic and clinical observations in three patients. Chest. 1989 May;95(5):1123-8 [MEDLINE]