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Search for: Carlos Nigro
INTRODUCTION: Patients that started on Non-Invasive Ventilation (NIV) need to define several parameters selected on the basis of diurnal arterial blood gas and underlying disease. We hypothesize that respiratory polygraphy (RP) could be useful to monitor NIV. This retrospective work describes RP findings and their impact on the setting of continuous flow ventilators from patients on NIV of Intensive Care Unit (ICU).
MATERIAL AND METHODS: Patient's data on NIV from at the ICU of Hospital Británico were included in this study. RP recordings were performed in all of them. Respiratory events, such as ventilatory pattern changes, impact on oximetry or tidal volume, were observed to modify the ventilatory mode after RP.
RESULTS: The RP findings have contributes to change the ventilatory mode for one third of the patients. The mean values of expiratory positive airway pressure (EPAP) and inspiratory positive airway pressure (IPAP) were not significantly different across all the population before or after RP: 8.7±0.3 vs. 8.6±0.4; p<0.88 and 18.6±0.6 vs. 17.7±0.7; p<0.26 respectively, however, half the patients presented > 2 cmH2O pressure value changes after RP.
CONCLUSIONS: RP recordings could contribute to broad range of data useful to make decisions about changes in programming and allowed to identify adverse events related to positive pressure.
Keywords: Oximetry; Noninvasive ventilation; Intensive care units; Blood gas analysis.
According to recent reports, sleep disorders affect 30% of the adult population and 5-10% of children. Obstructive Sleep Apnea Hypopnea Syndrome (OSA) has a considerable epidemiological impact and demand for consultation is growing in our community. Therefore, it is necessary to know the principles of interpretation of diagnostic methods. A suspicion of OSA requires confirmation. According to the guidelines of the Argentine Association of Respiratory Medicine, polysomnography (PSG) is the gold standard for OSA diagnosis, while home sleep testing (HST) can be accepted as a comparatively effective method depending on the clinical situation of the patient. This article questions the use of AHI (apnea-hypopnea index) as the only measurement needed to diagnose OSA and assess its severity. In fact, it is surprising that, despite the large mass of data analyzed during sleep studies, current practices only focus on AHI. More than four decades have passed since OSA was first described. Our tendency to oversimplify complex conditions may prevent us from gaining a deeper and more thorough understanding of OSA. The development and validation of OSA severity scoring systems based on multiple parameters is still a pending issue.
Keywords: Sleep Apnea Syndromes; Severity of Illness Index; Sleep Disorder.
PurposeObstructive Sleep Apnea-Hypopnea Syndrome (OSAS) is a public health problem.
We designed a pilot study to validate empiric indication of CPAP therapy in
a population with moderate-to-high pre-test probabilities who underwent
self-administered home-based respiratory polygraphy (RP). Conclusions STOP-BANG and ESS made it possible to indicate CPAP reliably (low rate of
false-positive results) in 20-40% of patients who needed such therapy
according to clinical history and RP results. These clinical criteria
performed better in male.
Keywords: Sleep Apnea Syndromes; Continuous Positive Airway Pressure; Decision Making
Introduction:The most effective treatment for moderate to severe obstructive sleep apnea
(OSA) is continuous positive airway pressure (CPAP) but adherence may be a
limiting factor. Most compliance studies often only include patients under
CPAP treatment, neglecting the importance of access to treatment. The aim of
this study was to evaluate CPAP access and compliance in OSA patients, after
CPAP indication and titration. Discussion:A significant proportion of OSA patients with CPAP indication did not
initiate and/or eventually abandoned CPAP. Approximately only 50% of the
patients were still under treatment, with acceptable self-reported adherence
rate and clinical response, one year after the initial treatment indication.
Additional measures are necessary to increase access to CPAP and improve
Keywords: Sleep Apnea; Obstructive; Continuous Positive Airway Pressure; Compliance; Education