Povitz Marcus, Kimoff R John
Can Respir J. 2014 Mar-Apr;21(2):96-100. doi: 10.1155/2014/214943. Epub 2013 Nov 28.
Sleep-disordered breathing (SDB) may impact the course of medical illness among hospitalized patients. Access to testing during hospitalization to assess this may be limited by wait times for laboratory polysomnography. Level 3 portable monitoring (PM) may provide an alternative.
To assess the rate of technically adequate studies, diagnostic information obtained and impact on patient management of inpatient PM studies performed for SDB.
A retrospective review of 114 PM (Embletta, Natus Inc, Canada) records from the past two years was performed. Studies were ordered by pulmonologists, initiated by respiratory therapists and performed unattended on inpatient units. Admitting diagnoses, indication for sleep study, diagnostic information obtained from recordings and change in clinical management subsequent to PM were determined from medical charts.
Of 114 studies reviewed, 99 (87%) met predetermined criteria for adequate signal quality and duration. Five studies could not be interpreted due to inadequate data, yielding an overall success rate of 83% (94 of 114). Of 86 studies performed for diagnosis, clinical and PM data supported a new diagnosis of SDB in 55 patients, of which 23 (42%) were started on positive pressure therapy. Thirteen PM studies were performed during SDB treatment. All were technically adequate and six of 13 demonstrated new or persistent SDB. Results from PM testing informed clinical management during hospitalization in 70 (61%) cases.
Unattended level 3 PM studies are technically feasible in hospitalized patients and may provide information that influences clinical management.
睡眠呼吸紊乱（SDB）可能会影响住院患者的病程。住院期间进行检测以评估这一情况可能会受到实验室多导睡眠图等待时间的限制。3级便携式监测（PM）可能是一种替代方法。
评估为SDB进行的住院PM研究的技术合格研究率、获得的诊断信息以及对患者管理的影响。
对过去两年的114份PM（Embletta，Natus公司，加拿大）记录进行回顾性研究。这些研究由肺科医生开出医嘱，由呼吸治疗师启动，并在住院病房无人值守的情况下进行。从病历中确定入院诊断、睡眠研究指征、从记录中获得的诊断信息以及PM后临床管理的变化。
在审查的114项研究中，99项（87%）符合信号质量和持续时间的预定标准。5项研究因数据不足无法解读，总体成功率为83%（114项中的94项）。在86项用于诊断的研究中，临床和PM数据支持55例患者新诊断为SDB，其中23例（42%）开始接受正压通气治疗。在SDB治疗期间进行了13项PM研究。所有研究在技术上都是合格的，13项中有6项显示出新的或持续存在的SDB。PM检测结果为70例（61%）住院期间的临床管理提供了依据。
在住院患者中，无人值守的3级PM研究在技术上是可行的，并且可能提供影响临床管理的信息。
