High prevalence of sleep-disordered breathing in the intensive care unit - a cross-sectional study.

Autor:	Bucklin AA; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Ganglberger W; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA.; Sleep & Health Zurich, University of Zurich, Zurich, Switzerland.; Henry and Allison McCance Center for Brain Health, MGH, Boston, MA, USA., Quadri SA; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Tesh RA; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Adra N; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Da Silva Cardoso M; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Leone MJ; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Krishnamurthy PV; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Hemmige A; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Rajan S; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Panneerselvam E; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Paixao L; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Higgins J; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Ayub MA; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Shao YP; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Ye EM; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Coughlin B; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA., Sun H; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA.; Henry and Allison McCance Center for Brain Health, MGH, Boston, MA, USA., Cash SS; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA., Thompson BT; Department of Medicine, MGH, Boston, MA, USA., Akeju O; Henry and Allison McCance Center for Brain Health, MGH, Boston, MA, USA.; Department of Anesthesia, Critical Care and Pain Medicine, MGH, Boston, MA, USA., Kuller D; MyAir Inc, Boston, MA, USA., Thomas RJ; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA.; Department of Medicine, Division of Pulmonary, Critical Care & Sleep, Beth Israel Deaconess Medical Center, Boston, MA, USA., Westover MB; Department of Neurology, Massachusetts General Hospital (MGH), 55 Fruit Street, Boston, MA, 02114, USA. mwestover@mgh.harvard.edu.; Clinical Data Animation Center (CDAC), MGH, Boston, MA, USA. mwestover@mgh.harvard.edu.; Henry and Allison McCance Center for Brain Health, MGH, Boston, MA, USA. mwestover@mgh.harvard.edu.
Jazyk:	angličtina
Zdroj:	Sleep & breathing = Schlaf & Atmung [Sleep Breath] 2023 Jun; Vol. 27 (3), pp. 1013-1026. Date of Electronic Publication: 2022 Aug 16.
DOI:	10.1007/s11325-022-02698-9
Abstrakt:	Purpose: Sleep-disordered breathing may be induced by, exacerbate, or complicate recovery from critical illness. Disordered breathing during sleep, which itself is often fragmented, can go unrecognized in the intensive care unit (ICU). The objective of this study was to investigate the prevalence, severity, and risk factors of sleep-disordered breathing in ICU patients using a single respiratory belt and oxygen saturation signals. Methods: Patients in three ICUs at Massachusetts General Hospital wore a thoracic respiratory effort belt as part of a clinical trial for up to 7 days and nights. Using a previously developed machine learning algorithm, we processed respiratory and oximetry signals to measure the 3% apnea-hypopnea index (AHI) and estimate AH-specific hypoxic burden and periodic breathing. We trained models to predict AHI categories for 12-h segments from risk factors, including admission variables and bio-signals data, available at the start of these segments. Results: Of 129 patients, 68% had an AHI ≥ 5; 40% an AHI > 15, and 19% had an AHI > 30 while critically ill. Median [interquartile range] hypoxic burden was 2.8 [0.5, 9.8] at night and 4.2 [1.0, 13.7] %min/h during the day. Of patients with AHI ≥ 5, 26% had periodic breathing. Performance of predicting AHI-categories from risk factors was poor. Conclusions: Sleep-disordered breathing and sleep apnea events while in the ICU are common and are associated with substantial burden of hypoxia and periodic breathing. Detection is feasible using limited bio-signals, such as respiratory effort and SpO 2 signals, while risk factors were insufficient to predict AHI severity. (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
Databáze:	MEDLINE
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