睡眠呼吸障碍期间的经皮二氧化碳

Transcutaneous carbon dioxide during sleep-disordered breathing.

作者信息

Rimpilä Ville, Hosokawa Keisuke, Huhtala Heini, Saaresranta Tarja, Salminen Aaro V, Polo Olli

机构信息

School of Medicine, University of Tampere, Finland; Unesta Research Center, Tampere, Finland.

Unesta Research Center, Tampere, Finland.

出版信息

Respir Physiol Neurobiol. 2015 Dec;219:95-102. doi: 10.1016/j.resp.2015.10.002. Epub 2015 Oct 22.

DOI:10.1016/j.resp.2015.10.002

PMID:26474829

Abstract

Respiratory drive is tightly controlled by the carbon dioxide levels. We tested the hypothesis that sequences of sleep apnoea (obstructive, central or mixed), hypopnoea and flow limitation are characterized by different levels of transcutaneous CO2 (PtcCO2). Polygraphic recordings (n=555) from patients with suspected sleep-disordered breathing (SDB) were retrospectively screened to find sequences (5 min or 10 events) of both SDB and steady breathing. Eighty-eight SDB sequences from 44 patients were included and PtcCO2 and SpO2 values were collected. PtcCO2 values during sequences were normalized by setting wakefulness level as 100%. In terms of PtcCO2, apnoea sequences with central component (central (n=7) and mixed (n=3) apnoea) did not differ from wakefulness (102.0% vs 100%, p=0.122) whereas obstructive apnoea (105.8%, p<0.001) and hypopnoea did (105.4%, p<0.001). PtcCO2 during flow limitation was higher than that during any other sequence, including steady breathing (112.2% vs 108.4%, p=0.022). Continuous PtcCO2 monitoring during sleep adds to the understanding of different SDB phenotypes.

摘要

呼吸驱动受二氧化碳水平的严格控制。我们检验了以下假设：睡眠呼吸暂停（阻塞性、中枢性或混合性）、呼吸浅慢和气流受限的序列具有不同水平的经皮二氧化碳（PtcCO2）。对疑似睡眠呼吸障碍（SDB）患者的多导睡眠图记录（n = 555）进行回顾性筛查，以找出SDB和稳定呼吸的序列（5分钟或10次事件）。纳入了44例患者的88个SDB序列，并收集了PtcCO2和SpO2值。通过将清醒水平设定为100%，对序列期间的PtcCO2值进行标准化。就PtcCO2而言，具有中枢成分的呼吸暂停序列（中枢性（n = 7）和混合性（n = 3）呼吸暂停）与清醒状态无差异（102.0%对100%，p = 0.122），而阻塞性呼吸暂停（105.8%，p<0.001）和呼吸浅慢则有差异（105.4%，p<0.001）。气流受限期间的PtcCO2高于任何其他序列，包括稳定呼吸期间（112.2%对108.4%，p = 0.022）。睡眠期间持续监测PtcCO2有助于加深对不同SDB表型的理解。