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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)
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.
Retrospective case series analyzed consecutively.
Multidisciplinary neuromuscular respiratory failure (NMRF) clinic at an academic institution.
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).
A respiratory therapist brought a calibrated tc-Pco2/Spo2 monitor to the patients home and provided instructions for data collection during the subjects 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.
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.
Home-based, unsupervised monitoring with tc-Pco2/Spo2 is a useful method for diagnosing NH in NMRF."
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in Archives of Physical Medicine and Rehabilitation > 2013/1 (2013) . - pp. 46-52[article]Microcirculatory Assessment of Arterial Below-Knee Stumps: Near-Infrared Spectroscopy Versus Transcutaneous Oxygen TensionA Preliminary Study in Prosthesis Users / Davy Laroche in Archives of Physical Medicine and Rehabilitation, 2017/6 (2017)
Titre : Microcirculatory Assessment of Arterial Below-Knee Stumps: Near-Infrared Spectroscopy Versus Transcutaneous Oxygen TensionA Preliminary Study in Prosthesis Users Type de document : Article Auteurs : Davy Laroche ; José-Luis Barnay ; Bastien Tourlonias Article en page(s) : pp. 11871194 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation
Mots-clés : Amputation stumps Moignons d'amputation Blood Gas Monitoring Transcutaneous Mesure transcutanée des gaz du sang Spectroscopy near-infrared Spectroscopie proche infrarouge Résumé : Objective
To examine metrologic properties of near-infrared spectroscopy (NIRS) versus transcutaneous oxygen tension (TcPO2) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO2 (borderline area between 15 and 35mmHg).
Prospective single-center observational study.
University-based rehabilitation center.
Individuals with unilateral transtibial amputation for peripheral artery disease, at the definitive stage of prosthesis fitting, able to perform a 2-minute walk test (N=30).
Main Outcome Measures
Test-retest, with the stump being evaluated in supine and inclined positions, first by NIRS (tissue saturation index [TSI], oxyhemoglobin, deoxyhemoglobin, and total hemoglobin) and second by TcPO2. Subjects carried out a 2-minute walk test and visual analog scales (wound healing and pain).
Feasibility and tolerance of NIRS were satisfactory. The reliability of NIRS and TcPO2 values was good (intraclass correlation coefficient >0.7; P<.05 no significant relation was found between nirs and tcpo2. responsiveness vs supine reported>.05). A significant relation between TSI and the 2-minute walk test (r>.49, P<.05 was found.> Conclusions
NIRS is painless, complication-free, and feasible, with good reliability. NIRS evaluates others domain than TcPO2 that are more linked to metabolic adaptation. Its capacity to predict stump healing and tolerance to early prosthesis fitting is therefore interesting to estimate in future studies.
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in Archives of Physical Medicine and Rehabilitation > 2017/6 (2017) . - pp. 11871194[article]