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The severity of sleep hypoventilation in stable chronic obstructive pulmonary disease
Sleep and Breathing ( IF 2.5 ) Pub Date : 2020-05-13 , DOI: 10.1007/s11325-020-02097-y
Ivar Ellingsen 1 , Ove Fondenes 2 , Britt Øverland 3 , Nils Henrik Holmedahl 1
Affiliation  

Purpose An increase in PaCO 2 is the element that defines sleep hypoventilation (SH). We queried if patients with SH, and those with PaCO 2 increases during sleep for shorter time periods than SH (shamSH) differed from the patients without SH (noSH) in other ways. Methods This was a retrospective re-analysis of data from 100 stable inpatients with COPD with and without chronic hypercapnic respiratory failure. COPD was defined by criteria of the Global initiative for Chronic Obstructive Lung Disease (GOLD). For this study, SH was defined by an increase in PaCO 2 ≥ 1.33 kPa to a value exceeding 6.7 kPa for ≥ 10 min (≥ 20 epochs of 30 s). Patients fulfilling the increase in PaCO 2 for less than 10 min (1–19 epochs) were designated shamSH. All patients had daytime arterial blood gases, lung function tests, and polysomnography (PSG) with transcutaneous CO 2 (PtcCO 2 ). Results Of 100 patients, 25 had PtcCO 2 increase ≥ 1.33 kPa. One never exceeded 6.7 kPa, 15 had SH, and 9 shamSH. SH and shamSH patients had extra CO 2 load (= PtcCO 2 *time) both during and between the SH periods compared to the noSH group, the SH group more than the shamSH group. Conclusion Using CO 2 load as a measure of severity of sleep hypoventilation, SH patients have worse hypoventilation than the shamSH. Both shamSH and SH groups have extra CO 2 load during and between SH periods, indicating that the SH/shamSH patients may represent a separate group of true hypoventilators during sleep.

中文翻译:

稳定期慢性阻塞性肺疾病睡眠通气不足的严重程度

目的 PaCO 2 的增加是定义睡眠换气不足 (SH) 的因素。我们询问了 SH 患者和 PaCO 2 增加的时间比 SH 短的患者(shamSH)是否在其他方面与没有 SH 的患者(noSH)有所不同。方法 这是对 100 名患有慢性高碳酸血症和不伴有慢性高碳酸血症呼吸衰竭的稳定住院患者的数据进行的回顾性再分析。COPD 由全球慢性阻塞性肺疾病倡议 (GOLD) 的标准定义。在这项研究中,SH 的定义是 PaCO 2 ≥ 1.33 kPa 增加到超过 6.7 kPa 的值,持续≥ 10 分钟(≥ 20 个 30 秒的纪元)。在不到 10 分钟(1-19 个时期)内实现 PaCO 2 增加的患者被指定为 shamSH。所有患者均进行了日间动脉血气、肺功能检查、和多导睡眠图 (PSG) 与经皮 CO 2 (PtcCO 2 )。结果 100 名患者中,25 名 PtcCO 2 增加≥ 1.33 kPa。一个从未超过 6.7 kPa,15 个有 SH,9 个有假SH。与noSH 组相比,SH 和shamSH 患者在SH 期间和之间都有额外的CO 2 负荷(= PtcCO 2 *时间),SH 组比shamSH 组多。结论 使用 CO 2 负荷作为睡眠通气不足严重程度的衡量标准,SH 患者的通气不足比假 SH 患者的通气不足更严重。在 SH 期间和 SH 期间,shamSH 和 SH 组都有额外的 CO 2 负荷,表明 SH/shamSH 患者可能代表睡眠期间真正的低通气机的独立组。与noSH 组相比,SH 和shamSH 患者在SH 期间和之间都有额外的CO 2 负荷(= PtcCO 2 *时间),SH 组比shamSH 组多。结论 使用 CO 2 负荷作为睡眠通气不足严重程度的衡量标准,SH 患者的通气不足比假 SH 患者的通气不足更严重。在 SH 期间和 SH 期间,shamSH 和 SH 组都有额外的 CO 2 负荷,表明 SH/shamSH 患者可能代表睡眠期间真正的低通气机的独立组。与noSH 组相比,SH 和shamSH 患者在SH 期间和之间都有额外的CO 2 负荷(= PtcCO 2 *时间),SH 组比shamSH 组多。结论 使用 CO 2 负荷作为睡眠通气不足严重程度的衡量标准,SH 患者的通气不足比假 SH 患者的通气不足更严重。在 SH 期间和 SH 期间,shamSH 和 SH 组都有额外的 CO 2 负荷,表明 SH/shamSH 患者可能代表睡眠期间真正的低通气机的独立组。
更新日期:2020-05-13
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