Chen Po-Yueh, Viet-Nhi Nguyen-Kieu, Chen Yen-Chun, Kao Yi-Lin, Dang Luong Huu, Hung Shih-Han
Department of Otolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei 110, Taiwan.
Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Healthcare (Basel). 2023 May 15;11(10):1436. doi: 10.3390/healthcare11101436.
During the SARS-CoV-2 pandemic, the use of in-laboratory positive airway pressure (PAP) titration studies was not routinely suggested. PAP pressure prediction calculations are emerging as alternative methods for the treatment of these patients. The underestimation of PAP titration pressure usually leads to unsatisfactory results for PAP therapy. This study aimed to evaluate the factors associated with the underestimation of PAP titration pressure when using PAP pressure prediction equations. Estimated PAP pressure formulas based on body mass index (BMI) and apnea-hypopnea index (AHI) were chosen to validate the accuracy of equations in the successful prediction of titration pressure. Among 341 adult patients diagnosed with obstructive sleep apnea (OSA) by overnight polysomnography (PSG) and who received overnight PAP titration in order to select a successful pressure, the mean age of the total subjects was 55.4 years old and 78.9% of patients were male. The average BMI and AHI scores were 27.1 ± 4.8 and 37 ± 21.7, respectively. After multivariate stepwise regression analysis, the odds ratio of participants with a pretitration AHI was 1.017 (95% CI: 1.005-1.030). Only the severity of OSA was significantly different between the underestimated group and the adequately assessed group. In conclusion, a high AHI, but not BMI, is associated with an underestimated CPAP titration pressure in adult patients with OSA.
在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间，实验室中常规不建议进行气道正压（PAP）滴定研究。PAP压力预测计算正成为治疗这些患者的替代方法。PAP滴定压力的低估通常会导致PAP治疗效果不理想。本研究旨在评估使用PAP压力预测方程时与PAP滴定压力低估相关的因素。选择基于体重指数（BMI）和呼吸暂停低通气指数（AHI）的估计PAP压力公式，以验证方程在成功预测滴定压力方面的准确性。在341例通过夜间多导睡眠图（PSG）诊断为阻塞性睡眠呼吸暂停（OSA）并接受夜间PAP滴定以选择合适压力的成年患者中，所有受试者的平均年龄为55.4岁，78.9%的患者为男性。平均BMI和AHI评分分别为27.1±4.8和37±21.7。经过多因素逐步回归分析，滴定前AHI参与者的优势比为1.017（95%CI：1.005-1.030）。低估组和评估充分组之间仅OSA严重程度存在显著差异。总之，在成年OSA患者中，高AHI而非BMI与CPAP滴定压力低估相关。
