samenvoeging topicsOp de vraag of het 'in een zakje blazen helpt of gevaarlijk is', hier de literatuur die ik er over heb kunnen vinden:
Hyperventilation Management: The Effectiveness of Rebreathing Bag and Breathing Retraining Techniques Mr. Ngian Bang See, Advanced Diploma of Emergency Nursing, Diploma in Nursing
Accident and Emergency Department, Changi General Hospital, Singapore
Objective: Most common current practice in managing hyperventilation symptoms in the Accident and Emergency Department is by rebreathing bag. However, reviews of the literature have suggested that breathing retraining technique could effectively control symptom. This study compares the effectiveness of managing hyper-ventilation symptoms with either of these techniques.
Methods: A prospective randomized study was conducted over a period of three months in the Accident and Emergency Department of Changi General Hospital. Inclusion criteria includes all patients above 12 years old, SaO2 >95%, respiratory rate >22b/minute (min.). Exclusion criteria included a patient with asthma, pregnancy, and history of heart or lung problems. The odd numbered patients received a rebreathing bag and the even numbered patients received breathing retraining technique. Effectiveness of the management was measured in terms of response to the treatment rendered and the time taken for the symptom to subside with patient's verbalization of relief.
Results: A total of 31 patients were enrolled in this study. Sixteen received rebreathing bags and 15 received the breathing retraining technique. Three patients did not respond to either treatment. Twenty-eight samples were analyzed. The majority of patients who hyperventilate are within the age of 12 to 30 years old (n = 20 [71%]). Female patients are more likely to hyperventilate (n = 24 [86%]) as compared to men (n = 4 [14%]). Triggering factors includ-ed emotional stress (n = 10[36%]) followed by high fever (n = 7[25%]). The average time taken for relief of hyper-ventilation symptoms for patients given the rebreathing bag was 26.6 min.; the breathing retraining technique took 45.7mins (p = 0.017 [>0.005]).
Conclusion: Although current practice advocates the rebreathing bag in the management of hyperventilation, the result of our study revealed that breathing retraining technique also elicits an effect as generally both groups responded to treatment. Nonetheless, breathing retraining technique required longer time to relieve the symptoms as compared to rebreathing bag.
Prehosp Disast Med 2001:16(3):S.
Hypoxic hazards of traditional paper bag rebreathing in hyperventilating patientsMD Michael Callaham
Received 10 November 1988; received in revised form 20 January 1989; accepted 30 January 1989.
It is traditional practice to treat acute hyperventilation (thought to be due to anxiety) by having patients rebreathe into a brown paper bag. The author reports three cases in which this treatment, erroneously applied to patients who were hypoxemic or had myocardial ischemia, resulted in death. This clinical experience motivated a study of the effects of paper bag rebreathing in normal volunteers. Subjects deliberately hyperventilated to an average end-tidal CO2 concentration of 21.6 (SD, 3.2) mm Hg and then continued to hyperventilate into a no. 4 Kraft brown paper bag containing the calibrated sensors for a Hewlett-Packard 47210A capnograph and a Teledyne TED 60J digital oxygen monitor. Fourteen men and six women with an average age of 36 years (SD, 6.1) were tested. Results are reported as mm Hg. After 30 seconds of rebreathing, mean change in O2 from room air was −15.9 (SD, 4.6) and mean CO2 was 38.7 (SD, 6.2); at 60 seconds, −20.5 (6.0) and 40.2 (6.4); at 90 seconds −22 (6.8 ) and 40.5 (6.4); at 120 seconds −23.6 (6.8 ) and 40.7 (6.5); at 150 seconds −25.1 (1.2) and 41 (7.3); and at 180 seconds −26.6 (8.4) and 41.3 (7.5). A few subjects achieved CO2 levels as high as 50, but many never reached 40. The mean maximal drop in O2 was 26 (8.8 ); seven subjects had drops in oxygen of 26 mm Hg at three minutes, four had drops of 34 mm Hg, and one had a drop of 42 mm Hg. Three subjects rebreathed into an 18-L plastic bag filled with 100% O2, but although CO2 rapidly exceeded 40, O2 levels reached 21% within two to four minutes and continued to decline to less than 10% at 15 minutes. Paper bag rebreathing decreases inspired oxygen sufficiently to endanger hypoxic patients. Paper bag rebreathing should never be administered unless myocardial ischemia can be ruled out and the patient's oxygenation has been directly measured by arterial blood gases or pulse oximetry Since these conditions are impossible to achieve outside the hospital, its recommendation and use by prehospital personnel should be abandoned, and its use in hospital probably should be diminished.
Volume 18, Issue 6, Pages 622-628 (June 1989)
En, hier is een mooie:
Question: Can I treat hyperventilation syndrome by breathing into a paper bag?Answer: Like many of the answers I give here, this one is a solid maybe as far as whether paper bags work. As far as whether you should use them to treat hyperventilation, the answer is definitely no -- unless your doctor tells you to do so.
Hyperventilation syndrome is usually associated with panic disorders. It is a psychological or emotional condition that causes victims to breathe too much. Breathing too deep and too fast causes the body to lose carbon dioxide (CO2), the byproduct of metabolism in our exhaled air. While CO2 is a byproduct, we still need a minimum amount in the bloodstream to maintain the proper pH balance in our bodies.
When we lose a significant amount of CO2, some body tissues start to malfunction. First, numbness develops in certain areas -- typically the lips, fingers and toes. After a while, the muscles of the hands and feet begin to cramp.
Paper bags have been used for years to treat hyperventilation syndrome. The idea is that rebreathing the air we exhale makes us inhale more CO2 and helps us to quickly add the CO2 back into our bloodstreams. It works. Breathing into a paper bag has been shown to increase CO2 levels in the blood, although not as quickly or as effectively as many doctors previously thought. In one study, patients who thought they were getting something similar to the paper bag treatment did nearly as well as the real paper bag group.
The problem with paper bags is not that true hyperventilation syndrome patients are at risk from the treatment. On the contrary, while it hasn't been shown to really help hyperventilation syndrome patients, it hasn't been shown to hurt them, either. What paper bags do hurt are the dangerous medical conditions that look like hyperventilation. Heart attacks and asthma are most commonly confused with hyperventilation syndrome.
Breathing into a paper bag restricts the fresh air you are able to get. Without fresh air, too little oxygen is in the air you're inhaling. So, breathing into a paper bag dangerously lowers the amount of oxygen in your bloodstream. There have been several documented cases of heart attack patients incorrectly thinking they had hyperventilation syndrome and fatally worsening their heart attacks by breathing into a paper bag.
To make matters worse, several studies now show a link between high concentrations of CO2 and panic attacks, which means that artificially increasing CO2 in inhaled air is likely to trigger more feelings of panic in patients who suffer from anxiety.
The best treatment of hyperventilation syndrome is to stay calm and practice breathing slowly and not too deeply. Calmness and breathing exercises have just as much success as paper bag breathing, and no one is going to die from staying calm.
Sources:
Callaham, M. "Hypoxic hazards of traditional paper bag rebreathing in hyperventilating patients." Annals of Emergency Medicine. Jun 1989 PMID: 2499228
van den Hout, M.A., et al."Rebreathing to cope with hyperventilation: experimental tests of the paper bag method." Journal of Behavioral Medicine. Jun 1988 PMID: 3139884
Ohi, M., et al."Oxygen desaturation following voluntary hyperventilation in normal subjects." American Journal of Respiratory and Critical Care Medicine. Mar 1994 PMID: 8118644
Griez, Eric J., et al. "Carbon Dioxide Inhalation Induces Dose-Dependent and Age-Related Negative Affectivity." PLoS ONE. 3 Oct 2007 PMID:
Bron:
http://firstaid.about.com/od/shortnessofbreat1/f/07_paper_bags.htmCONCLUSIE: Het kán werken, hoewel een placebo-effect niet is uit te sluiten, maar het gevaar bestaat dat een hartinfarct wordt aangezien voor een hyperventilatie-aanval, waarna het ademen in een zakje het zuurstofgehalte in het bloed zodanig kan verlagen dat het hart in VF gaat.
Tja, persoonlijk gebruik ik het zakje alleen bij jonge meisjes (in 5 jaar nog geen hyperventilerende jongen tegen gekomen) als al het andere niet werkt.
