睡眠呼吸障碍在从长时间机械通气中脱机的患者中可能未被充分识别。

Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation.

机构信息

University of Maryland School of Medicine, Baltimore, MD, USA.

出版信息

Respir Care. 2012 Feb;57(2):229-37. doi: 10.4187/respcare.01260. Epub 2011 Jul 12.

DOI:10.4187/respcare.01260

PMID:21762560

Abstract

BACKGROUND

The prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV.

METHODS

Retrospective chart review was conducted of all PMV patients who had in-patient polysomnography (PSG) between January 2007 and May 2010. Main outcome measures included the frequency of SDB and tracheostomy decannulation.

RESULTS

Nineteen patients were studied, age 53.4 ± 13.4 years, 11 males (57.9%), with mean body mass index of 44.0 ± 12.7 kg/m(2) (range 27.3-75.7). Eighteen patients (94.7%) demonstrated SDB as evidenced by obstructive sleep apnea (OSA), with a median respiratory disturbance index (RDI) of 24.2 events/h (range 5.9-82.0 events/h). Fourteen patients underwent successful positive airway pressure titration, with improvement in the median RDI to 0.9 events/h (range 0.0-9.1 events/h) (P < .001). Seventeen patients (89.5%) were decannulated without adverse event.

CONCLUSIONS

There may be a high prevalence of unrecognized SDB in patients who are candidates for decannulation after weaning from PMV.

摘要

背景

患有延长机械通气（PMV）的患者中睡眠呼吸障碍（SDB）的患病率尚不清楚。本研究的目的是评估在从 PMV 撤机后入住长期急性护理（LTAC）医院的患者中 SDB 的频率。

方法

对 2007 年 1 月至 2010 年 5 月期间在住院期间进行过多导睡眠图（PSG）的所有 PMV 患者进行回顾性图表审查。主要观察指标包括 SDB 的频率和气管造口套管的拔除。

结果

研究了 19 例患者，年龄为 53.4 ± 13.4 岁，男性 11 例（57.9％），平均体重指数为 44.0 ± 12.7 kg/m2（范围 27.3-75.7）。18 例（94.7％）患者表现出 SDB，证据为阻塞性睡眠呼吸暂停（OSA），中位呼吸紊乱指数（RDI）为 24.2 次/小时（范围 5.9-82.0 次/小时）。14 例患者成功进行了正压通气滴定，中位 RDI 改善至 0.9 次/小时（范围 0.0-9.1 次/小时）（P <.001）。17 例患者（89.5％）在无不良事件的情况下拔管。