trié(s) par (Pertinence décroissant(e), Titre croissant(e)) 

Home-Based Overnight Transcutaneous Capnography/Pulse Oximetry for Diagnosing Nocturnal Hypoventilation Associated With Neuromuscular Disorders / Kristy A Bauman in Archives of Physical Medicine and Rehabilitation, 2013/1 (2013)  

[article]  inArchives of Physical Medicine and Rehabilitation > 2013/1 (2013) . - pp. 46-52 Titre : Home-Based Overnight Transcutaneous Capnography/Pulse Oximetry for Diagnosing Nocturnal Hypoventilation Associated With Neuromuscular Disorders Type de document : Article Auteurs : Kristy A Bauman ; Armando Kurili ; L. Schmidt Shelley ; [et al.] Article en page(s) : pp. 46-52 Langues : Anglais (eng) Descripteurs : HE Vinci Hospitalisation à domicile ; Rééducation et réadaptation ; Syndromes d'apnées du sommeil Mots-clés : Blood gas monitoring  transcutaneous  Mesure transcutanée des gaz du sang  Home care services  hospital-based  Hypoventilation  Neuromuscular diseases  Maladies neuromusculaires  Sleep apnea syndromes Résumé : "Objective To determine the utility of home-based, unsupervised transcutaneous partial pressure of carbon dioxide (tc-Pco2) monitoring/oxygen saturation by pulse oximetry (Spo2) for detecting nocturnal hypoventilation (NH) in individuals with neuromuscular disorders. Design Retrospective case series analyzed consecutively. Setting Multidisciplinary neuromuscular respiratory failure (NMRF) clinic at an academic institution. Participants Subjects (N=35, 68.6% men; mean age, 46.9y) with spinal cord injury (45.7%) or other neuromuscular disorders underwent overnight tests with tc-Pco2/Spo2 monitoring. Fifteen (42.9%) were using nocturnal ventilatory support, either bilevel positive airway pressure (BiPAP) or tracheostomy ventilation (TV). Interventions A respiratory therapist brought a calibrated tc-Pco2/Spo2 monitor to the patient’s home and provided instructions for data collection during the subject’s normal sleep period. Forced vital capacity (FVC), body mass index (BMI), and exhaled end-tidal Pco2 (ET-Pco2) were recorded at a clinic visit before monitoring. Main Outcome Measures Detection of NH (tc-Pco2 ≥50mmHg for ≥5% of monitoring time). Data were also analyzed to determine whether nocturnal oxygen desaturation (Spo2 ≤88% for ≥5% of monitoring time), FVC, BMI, or daytime ET-Pco2 could predict the presence of NH. Results NH was detected in 18 subjects (51.4%), including 53.3% of those using BiPAP or TV. NH was detected in 43.8% of ventilator-independent subjects with normal daytime ET-Pco2 (present for 49.4%+31.5% [mean + SD] of the study period), and in 75% of subjects with an elevated daytime ET-Pco2 (present for 92.3%+8.7% of the study period). Oxygen desaturation, BMI, and FVC were poor predictors of NH. Only 3 attempted monitoring studies failed to produce acceptable results. Conclusions Home-based, unsupervised monitoring with tc-Pco2/Spo2 is a useful method for diagnosing NH in NMRF." Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117356 [article]

Simplified Approach to Diagnosing Sleep-Disordered Breathing and Nocturnal Hypercapnia in Individuals With Spinal Cord Injury / Kristy A Bauman in Archives of Physical Medicine and Rehabilitation, 2016/3 (2016)  

[article]  inArchives of Physical Medicine and Rehabilitation > 2016/3 (2016) . - pp. 363–371 Titre : Simplified Approach to Diagnosing Sleep-Disordered Breathing and Nocturnal Hypercapnia in Individuals With Spinal Cord Injury Type de document : Article Auteurs : Kristy A Bauman ; Armando Kurili ; Helena M. Schotland Article en page(s) : pp. 363–371 Langues : Anglais (eng) Descripteurs : HE Vinci Hypercapnie ; Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Hypercapnia  Spinal cord injuries Résumé : Objective To evaluate a strategy of home-based testing to diagnose sleep-disordered breathing and nocturnal hypercapnia in individuals with spinal cord injury (SCI). Design Case series. Setting Referral center. Participants Adults with C1-T6 SCI (N=81). Individuals were eligible if ≥18 years old, with SCI of ≥3 months' duration, living within 100 miles of the study site, and not meeting exclusion criteria. Of the 161 individuals recruited from the SCI Model System database who were not enrolled, reasons were not interested in participating, change of location, prior positive pressure ventilation use, or medical contraindication. Ten individuals did not complete the study. Interventions Performance of an unsupervised home sleep apnea test combined with transcutaneous partial pressure of carbon dioxide/oxygen saturation by pulse oximetry monitoring. Main Outcome Measures Prevalence of sleep-disordered breathing and nocturnal hypercapnia. Clinical and physiological variables were examined to determine which, if any, correlate with the severity of sleep-disordered breathing. Results Obstructive sleep apnea (OSA) was found in 81.3% of individuals, central sleep apnea (CSA) was found in 23.8%, and nonspecific hypopnea events, where respiratory effort was too uncertain to classify, were present in 35%. Nonspecific hypopnea events correlated strongly with CSA but weakly with OSA, suggesting that conventional sleep apnea test scoring may underestimate central/neuromuscular hypopneas. Nocturnal hypercapnia was present in 28% and oxygen desaturation in 18.3%. Neck circumference was the primary predictor for OSA, whereas baclofen use and obstructive apnea/hypopnea index weakly predicted CSA. Awake transcutaneous partial pressure of carbon dioxide and CSA were only marginally associated with nocturnal hypercapnia. Conclusions Unsupervised home sleep apnea testing with transcutaneous capnography effectively identifies sleep-disordered breathing and nocturnal hypercapnia in individuals with SCI. DOI : https://doi.org/10.1016/j.apmr.2015.07.026 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118105 [article]