2/26/2024 0 Comments Nocturnal hypoxemiaPathophysiological consequences of upper airway collapse include intermittent hypoxia and sleep fragmentation, resulting in sympathetic activation, systemic inflammation, and oxidative stress. The prevalence of symptomatic OSA is estimated to be 2–4% in the general population, in both children and adults ( 1, 2). Early screening for SRBDs and intervention with nocturnal supplemental oxygen and/or positive airway pressure as well as pulmonary endarterectomy may reduce adverse outcomes in patients with CTEPH.Obstructive sleep apnea (OSA) is a common chronic respiratory disorder characterized by sleep-induced recurrent upper airway collapse. Conclusions: Severe NH is highly prevalent in patients with CTEPH. Among the variables tested, age (odds ratio (OR) 1.08, 95% confidence interval 1.01–1.15 p = 0.031), mPAP (OR 1.11 ), and AHI (OR 1.17 ) were independent determinants of severe NH. Severe NH was observed in 31 (62%) patients. SRBD was observed in 40 (80%) patients, of whom 27 had OSA, 2 CSA–CSR, and 11 ISRH. The average mPAP was 43.8 (SD 16.8) mmHg. Results: In all, 50 consecutive patients (34 men and 16 women mean age 54.0 (SD 15.1) years) were included. SRBDs were defined as obstructive sleep apnea (OSA as an AHI ≥ 15 events/h), central sleep apnea with Cheyne–Stokes respiration (CSA–CSR CSR pattern ≥ 50% of TST), obesity hypoventilation syndrome (OHS), and isolated sleep-related hypoxemia (ISRH SpO 2 5 min without OSA, CSA, or OHS). Pulmonary hemodynamics (mean pulmonary arterial pressure (mPAP), pulmonary arterial wedge pressure (PAWP), pulmonary vascular resistance (PVR) measured with right heart catheterization (RHC)), PSG variables (apnea–hypopnea index (AHI)), lung function and carbon monoxide diffusion capacity (DLCO) values, as well as demographics and comorbidities were entered into a logistic regression model to address the determinants of severe NH (nocturnal oxyhemoglobin saturation (SpO 2) 20% of total sleep time (TST)). Methods: An overnight polysomnography (PSG) was conducted in patients with CTEPH, who were eligible for pulmonary endarterectomy. Objectives: We aimed to investigate the occurrence of sleep-related breathing disorders (SRBDs) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and addressed the effect of pulmonary hemodynamics and SRBD indices on the severity of nocturnal hypoxemia (NH). Pulmonary hemodynamics (mean pulmonary arterial pressure (mPAP), pulmonary arterial wedge pressure (PAWP), pulmonary vascular resistance (PVR) measured with right heart catheterization (RHC)), PSG variables (apnea–hypopnea index (AHI)), lung function and carbon monoxide diffusion capacity (DLCO) values, as well as demographics and. Çınar, Caner Yıldızeli, Şehnaz Olgun Balcan, Baran Yıldızeli, Bedrettin Mutlu, Bülent and Peker, Yüksel LU Determinants of Severe Nocturnal Hypoxemia in Adults with Chronic Thromboembolic Pulmonary Hypertension and Sleep-Related Breathing Disorders
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