Underestimation of Nocturnal Hypoxemia Due to Monitoring Conditions in Patients With COPD
| Autor: | F. Brijker, Frank J.J. van den Elshout, Yvonne F. Heijdra, Hans Th.M. Folgering |
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| Rok vydání: | 2001 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_specialty Polysomnography mogelijke oorzaken en gevolgen (sepsis en ontsteking) [Sepsis en niet-bacteriële gegeneraliseerde ontsteking] Nocturnal causes and effects (sepsis and inflammation) [Sepsis and non-bacterial generalized inflammation] Critical Care and Intensive Care Medicine Time Hypoxemia Internal medicine medicine Humans Control mechanisms in asthma and chronic obstructive pulmonary disease In patient Lung Diseases Obstructive Oximetry Hypoxia Aged Aged 80 and over COPD medicine.diagnostic_test business.industry Respiratory disease Middle Aged medicine.disease respiratory tract diseases Pulmonology Anesthesia Regulatie mechanismen bij astma en chronisch obstructieve longaandoeningen Breathing Physical therapy Female medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Chest, 119, 1820-6 Chest, 119, 6, pp. 1820-6 |
| ISSN: | 0012-3692 |
| DOI: | 10.1378/chest.119.6.1820 |
| Popis: | Item does not contain fulltext STUDY OBJECTIVES: COPD patients run a risk of developing nocturnal oxygen desaturation. When evaluating patients with nocturnal hypoxemia, an unfamiliar hospital environment and the monitoring equipment may cause sleep disturbances. It was hypothesized that increased sleep disruption will lead to fewer instances of desaturation during a night of monitoring. DESIGN:The following forms of monitoring were evaluated prospectively on 3 nights for each patient: oximetry at home; polysomnography (PSG) at home; and PSG in the hospital. SETTING: Department of Pulmonology, Rijnstate Hospital Arnhem, The Netherlands. PATIENTS: Fourteen stable COPD patients (7 men; median age, 71.5 years; age range, 59 to 81 years; FEV(1), 32.5% predicted; FEV(1) range, 19 to 70% predicted) participated in the study. All subjects had significant instances of nocturnal arterial oxygen desaturation. Those patients with a sleep-related breathing disorder or cardiac failure were excluded from the study. MEASUREMENTS AND RESULTS: The mean nocturnal arterial oxygen saturation (SaO(2)) level was higher during PSG monitoring at home (89.7%; range, 77 to 93%) than during oximetry monitoring (88.5%; range, 80 to 92%) [p < 0.025]. The fraction of time spent in hypoxemia (ie, SaO(2) < 90%) was lower during PSG monitoring at home (40.8%; range, 5 to 100%) than during oximetry monitoring (59.9%; range, 6 to 100%) [p < 0.01]. Desaturation time (DeltaSaO(2) > 4%) was lower during PSG monitoring at home (22.1%; range, 3 to 63%) during PSG monitoring at home than during oximetry monitoring (50.4%; range, 4 to 91%) [p < 0.01]. A correction for actual sleep during PSG monitoring reduced the differences between PSG monitoring at home and oximetry monitoring, although a difference in the desaturation time remained (PSG monitoring at home, 31.9% [range, 2 to 75%]; oximetry monitoring, 50.4% [range, 4 to 91%]) [p = 0.041]. A comparison of sleep architectures for nights when PSG was being monitored showed a higher arousal index in the hospital than at home (PSG monitoring in the hospital, 5.6 arousals per hour [range, 2 to 16 arousals per hour]; PSG monitoring at home, 2.5 arousals per hour [range, 1 to 6 arousals per hour]) [p < 0.025], but no differences in SaO(2) levels were found between PSG monitoring at home and PSG monitoring in the hospital. CONCLUSION: The artifacts due to sleep-monitoring equipment may cause an underestimation of the degree of nocturnal hypoxemia in COPD patients. The addition of an unfamiliar environment causes more sleep disruption, but this does not affect nocturnal SaO(2) levels further. |
| Databáze: | OpenAIRE |
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