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上气道刺激后中枢性和混合性睡眠呼吸暂停指数升高。

Elevated Central and Mixed Apnea Index after Upper Airway Stimulation.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

出版信息

Otolaryngol Head Neck Surg. 2020 May;162(5):767-772. doi: 10.1177/0194599820912740. Epub 2020 Mar 17.

Abstract

OBJECTIVE

Upper airway stimulation (UAS) is used to treat patients with moderate to severe obstructive sleep apnea (OSA). The aim of this study is to report the incidence and potential predictors of elevated central and mixed apnea index (CMAI) after UAS.

STUDY DESIGN

Retrospective chart review of patients undergoing UAS.

SETTING

Tertiary care center.

SUBJECTS AND METHODS

Included patients underwent UAS for OSA at our institution between 2014 and 2018. Data collected included demographic information, implantation records, and pre- and postoperative polysomnography (PSG) results. CMAI ≥5 was considered elevated. Post hoc univariate analysis was performed to evaluate factors associated with elevated CMAI.

RESULTS

In total, 141 patients underwent UAS at our institution. This included 94 men and 47 women with a mean age of 61.2 ± 11.0 years and a mean body mass index of 29.1 ± 3.9 kg/m. Five patients had an elevated CMAI after surgery during UAS titration. Demographics, comorbid conditions, and device settings were not associated with an elevated postoperative CMAI ( > .05).

CONCLUSION

The occurrence of an elevated CMAI after surgery may represent treatment-emergent events. Demographics, comorbid conditions, and UAS device settings were not associated with central and mixed apneic events.

LEVEL OF EVIDENCE

摘要

目的

上气道刺激(UAS)用于治疗中重度阻塞性睡眠呼吸暂停(OSA)患者。本研究旨在报告 UAS 后中枢性和混合性呼吸暂停指数(CMAI)升高的发生率和潜在预测因素。

研究设计

回顾性分析接受 UAS 治疗的患者图表。

地点

三级护理中心。

受试者和方法

纳入的患者于 2014 年至 2018 年在我院因 OSA 接受 UAS。收集的数据包括人口统计学信息、植入记录以及术前和术后多导睡眠图(PSG)结果。CMAI≥5 被认为升高。进行事后单变量分析以评估与升高的 CMAI 相关的因素。

结果

共有 141 名患者在我院接受 UAS。其中包括 94 名男性和 47 名女性,平均年龄为 61.2±11.0 岁,平均体重指数为 29.1±3.9kg/m。在 UAS 滴定期间,有 5 名患者术后 CMAI 升高。人口统计学、合并症和设备设置与术后升高的 CMAI 无关(>.05)。

结论

手术后 CMAI 升高可能代表治疗后出现的事件。人口统计学、合并症和 UAS 设备设置与中枢性和混合性呼吸暂停事件无关。

证据水平

4。

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