Non-Invasive Mechanical Ventilation in Chemical Lung Veterans with Obstructive Sleep Apnea

2020 ◽  
Author(s):  
Ghasem Jalali ◽  
Fariba Rezaeetalab ◽  
Fariborz Rezaeitalab ◽  
Negar Morovatdar ◽  
Mahnaz Mozdourian ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Invasive Mechanical Ventilation ◽  
Non Invasive ◽  
Obstructive Sleep

551 Outcomes of Sickle Cell Crisis in Relation to Pediatric Obstructive Sleep Apnea in the United States: A US Population cohort study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A218-A218
Author(s):  
Palakkumar Patel ◽  
Tomas Munoz ◽  
Pranshu Adavadkar
Keyword(s):  
Mechanical Ventilation ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sickle Cell ◽  
Invasive Mechanical Ventilation ◽  
The United States ◽  
Hospitalization Cost ◽  
Obstructive Sleep ◽  
Sickle Cell Crisis ◽  
Total Hospitalization Cost

Abstract Introduction This study aimed to quantify the impact of obstructive sleep apnea (OSA) on the mortality, morbidity, and resources utilization among children admitted with Sickle cell crisis (SCC) Methods This is a retrospective analysis using the 2016 and 2017 National Inpatient Sample Database. The Inclusion Criteria was a principal Diagnosis of SSC and age <18 years. OSA, as a Secondary Diagnosis, was identified using the appropriate ICD-10 CM codes. The Primary Outcomes were Inpatient Mortality, and secondary outcomes were: In-Hospital Length of Stay(LOS), Total hospitalization Cost, Blood transfusion (BT) requirement, and a requirement for Invasive mechanical ventilation (IMV). We used Multivariate Linear/ logistic regression to adjust for confounders including age and sex. Results Out of 36,484 children with SSC included in the study, 1450 children had OSA (SCC+OSA). SSC-OSA and SSC+OSA groups did not differ in gender, household income, and hospital characteristics, but did so in age (11.3 vs 12.4; p <0.001). OSA was most common in the age group of 13–18 (54%) and lowest in 0–4 (2.4%). Compared to SSC-OSA, the SCC+OSA cohort had significantly higher odds of mortality (adjusted OR= 11.9, [95% Confidence Interval: 1.02- 138.8],p=0.04). Additionally, SSC+OSA cohort was associated with increased odds of IMV (aOR=5.24 [CI: 1.84 – 14.8], p=0.002), longer LOS (adjusted mean difference (aMD)=0.67 [CI-0.32 – 1.02], p=<0.001), and higher hospitalization Cost (aMD=2818.76 [CI-1680- 4157], p=<0.001). No difference in BT (aOR=0.94 [CI: 0.68 – 1.29], p=0.71) was noted. Conclusion This study demonstrates that the presence of OSA is associated with detrimental outcomes in SSC with higher in-hospital mortality, higher morbidity (Invasive mechanical ventilation rate), and higher resource utilization (LOS, total hospitalization cost). More attention to the screening, early diagnosis, and appropriate treatment of OSA is imperative to improve health outcomes in children with sickle cell disease. Support (if any):

scholarly journals Sleep-related breathing disorders and non-invasive ventilation

2015 ◽  
Vol 9 (2) ◽  
pp. 109
Author(s):  
Agata Lax ◽  
Simona Colamartino ◽  
Paolo Banfi ◽  
Antonello Nicolini
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Neuromuscular Disorders ◽  
Invasive Mechanical Ventilation ◽  
Patient Acceptance ◽  
Invasive Ventilation ◽  
Respiratory Impairment ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

Non-invasive mechanical ventilation (NPPV) was originally used in patients with acute respiratory impairment or exacerbations of chronic respiratory diseases, as an alternative to the endotracheal tube. Over the last thirty years NPPV has been also used at night in patients with stable chronic lung disease such as obstructive sleep apnea, the overlap syndrome (chronic obstructive pulmonary disease and obstructive sleep apnea), neuromuscular disorders, obesity-hypoventilation syndrome, and in other conditions such as sleep disorders associated with congestive heart failure (Cheyne-Stokes respiration). In this no-systematic review we discuss the different types of NPPV, the specific conditions in which they can be used and the indications, recommendations and evidence supporting the efficacy of NPPV. Optimizing patient acceptance and adherence to non-invasive ventilation treatment is challenging. The treatment of sleep-related disorders is a life-threatening condition. The optimal level of treatment should be determined in a sleep laboratory. Side effects directly affecting the patient’s adherence to treatment are known. The most common are nasopharyngeal symptoms including increased congestion and rhinorrhea; these effects are related to reduced humidity of inspired gas. Humidification of delivered gas may improve these symptoms.

scholarly journals Recurrent Pneumothorax with CPAP Therapy for Obstructive Sleep Apnea

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Kartikeya Rajdev ◽  
Pretty Sara Idiculla ◽  
Shubham Sharma ◽  
Susanna G. Von Essen ◽  
Peter J. Murphy ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Diaphragmatic Hernia ◽  
Invasive Mechanical Ventilation ◽  
Positive Pressure ◽  
Cpap Therapy ◽  
Pulmonary Barotrauma ◽  
Sleep Study ◽  
Pressure Therapy ◽  
Obstructive Sleep

Pulmonary barotrauma such as pneumothorax (PTX) is a known complication of invasive mechanical ventilation. However, it is uncommonly reported with the use of noninvasive positive pressure ventilation (NPPV) and CPAP (continuous positive airway pressure) therapy. We present a case of a 66-year-old female who presented with chronic dyspnea on exertion secondary to right-sided diaphragmatic hernia. The patient also underwent a home sleep study which suggested obstructive sleep apnea (OSA) for which she was initiated on CPAP. She then underwent surgical repair of her right diaphragmatic hernia. The patient developed pneumothorax three times over the course of the following several months, once on the right side and twice on the left side. The patient’s incidences of PTX had a temporal association with the CPAP initiation. Her CPAP therapy was discontinued permanently after the third occurrence of PTX. With this case report, we highlight the risk of barotrauma with the use of CPAP for OSA. There are very few reported cases of PTX in association with NPPV therapy for OSA. The lung-protective ventilation strategies and limiting the positive airway pressures can help reduce the risk of pulmonary barotrauma with CPAP.

scholarly journals Copeptin, Pro-atrial Natriuretic Peptide and Pro-adrenomedullin as Markers of Hypoxic Stress in Patients With Obstructive Sleep Apnea - a Prospective Intervention Study

2021 ◽  
Author(s):  
Meropi Karakioulaki ◽  
Peter Grendelmeier ◽  
Werner Strobel ◽  
Thomas Schmid ◽  
Kathleen Jahn ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Therapy Response ◽  
Cpap Therapy ◽  
Non Invasive ◽  
Acute Response ◽  
Venous Puncture ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

Abstract Study Objectives: Obstructive sleep apnea (OSA) might lead to oxidative stress, inflammation and elevated circulating copeptin, proANP and proADM levels. We aimed to evaluate whether the levels of these prohormones are higher in patients with OSA and whether they might change under continuous positive airway pressure (CPAP) therapy, serving as potential proxies for the diagnosis and therapy-response in OSA. Methods: A total of 310 patients with suspicion of OSA were recruited. Screening for OSA was performed using overnight pulse oximetry followed by polygraphy and a venous puncture in the morning. All patients diagnosed with OSA underwent CPAP adaptation. A venous puncture was conducted in the night before CPAP and in the following morning. At 1 and 6 months of treatment, polygraphy was performed, followed by a venous puncture in the morning. In the acquired blood, copeptin, proANP and proADM levels were measured.Results: We analyzed 232 patients with OSA and 30 patients without OSA. Our results indicated that only copeptin levels differed significantly among patients with and without OSA at baseline. In OSA patients, the levels of proADM significantly changed after 1 and 6 months on CPAP therapy, when compared to baseline (p<0.001 and p=0.020). Additionally, proANP levels significantly decreased after 12 hours on CPAP therapy, as compared to baseline levels (p<0.001). Conclusions: Copeptin is significantly associated with the presence of OSA. ProANP levels might serve as a potential proxy for the acute response to non-invasive ventilation (12 hours), while proADM reflects the long-term response (1 and 6 months).

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