Obstructive sleep apnea in patients surviving acute hypercapnic respiratory failure is best predicted by static hyperinflation
Acute hypercapnic respiratory failure (AHRF) treated with non-invasive ventilation in the ICU is frequently caused by chronic obstructive pulmonary disease (COPD) exacerbations and obesity-hypoventilation syndrome, the latter being most often associated with obstructive sleep apnea. Overlap syndrome...
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| creator | Adler, Dan Dupuis-Lozeron, Elise Janssens, Jean Paul Soccal, Paola M Lador, Frédéric Brochard, Laurent Pépin, Jean-Louis |
| description | Acute hypercapnic respiratory failure (AHRF) treated with non-invasive ventilation in the ICU is frequently caused by chronic obstructive pulmonary disease (COPD) exacerbations and obesity-hypoventilation syndrome, the latter being most often associated with obstructive sleep apnea. Overlap syndrome (a combination of COPD and obstructive sleep apnea) may represent a major burden in this population, and specific diagnostic pathways are needed to improve its detection early after ICU discharge.
To evaluate whether pulmonary function tests can identify a high probability of obstructive sleep apnea in AHRF survivors and outperform common screening questionnaires to identify the disorder.
Fifty-three patients surviving AHRF (31 males; median age 67 years (interquartile range: 62-74) participated in the study. Anthropometric data were recorded and body plethysmography was performed 15 days after ICU discharge. A sleep study was performed 3 months after ICU discharge.
The apnea-hypopnea index was negatively associated with static hyperinflation as measured by the residual volume to total lung capacity ratio in the % of predicted (coefficient = -0.64; standard error 0.17; 95% CI -0.97 to -0.31; p |
| doi_str_mv | 10.1371/journal.pone.0205669 |
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To evaluate whether pulmonary function tests can identify a high probability of obstructive sleep apnea in AHRF survivors and outperform common screening questionnaires to identify the disorder.
Fifty-three patients surviving AHRF (31 males; median age 67 years (interquartile range: 62-74) participated in the study. Anthropometric data were recorded and body plethysmography was performed 15 days after ICU discharge. A sleep study was performed 3 months after ICU discharge.
The apnea-hypopnea index was negatively associated with static hyperinflation as measured by the residual volume to total lung capacity ratio in the % of predicted (coefficient = -0.64; standard error 0.17; 95% CI -0.97 to -0.31; p<0.001). A similar association was observed in COPD patients only: coefficient = -0.65; standard error 0.19; 95% CI -1.03 to -0.26; p = 0.002. Multivariate analysis with penalized maximum likelihood confirmed that the residual volume to total lung capacity ratio was the main contributor for apnea-hypopnea index variance in addition to classic predictors. Screening questionnaires to select patients at risk for sleep-disordered breathing did not perform well.
In AHRF survivors, static hyperinflation is negatively associated with the apnea-hypopnea index in both COPD and non-COPD patients. Measuring static hyperinflation in addition to classic predictors may help to increase the recognition of obstructive sleep apnea as common screening tools are of limited value in this specific population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205669</identifier><identifier>PMID: 30359410</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Airway management ; Anthropometry ; Apnea ; Biology and Life Sciences ; Chronic illnesses ; Chronic obstructive lung disease ; Chronic obstructive pulmonary disease ; Complications and side effects ; Critical care ; Diagnosis ; Diagnostic systems ; Discharge ; Hospitals ; Hypertension ; Hypoventilation ; Identification methods ; Lung diseases ; Males ; Mechanical ventilation ; Medicine ; Medicine and Health Sciences ; Multivariate analysis ; Obesity ; Obstructive lung disease ; Patients ; Physical Sciences ; Physiology ; Plethysmography ; Population ; Pulmonary functions ; Research and Analysis Methods ; Respiratory failure ; Respiratory function ; Risk factors ; Screening ; Sleep ; Sleep apnea ; Sleep disorders ; Standard error ; Studies ; Ventilation ; Ventilators</subject><ispartof>PloS one, 2018-10, Vol.13 (10), p.e0205669-e0205669</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Adler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Adler et al 2018 Adler et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-588e20908b99883e53ab7841a16dd2146f0bf8bb92df7600c588275762deea9d3</citedby><cites>FETCH-LOGICAL-c692t-588e20908b99883e53ab7841a16dd2146f0bf8bb92df7600c588275762deea9d3</cites><orcidid>0000-0002-9915-862X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201889/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201889/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23847,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30359410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Lee, Pei-Lin</contributor><creatorcontrib>Adler, Dan</creatorcontrib><creatorcontrib>Dupuis-Lozeron, Elise</creatorcontrib><creatorcontrib>Janssens, Jean Paul</creatorcontrib><creatorcontrib>Soccal, Paola M</creatorcontrib><creatorcontrib>Lador, Frédéric</creatorcontrib><creatorcontrib>Brochard, Laurent</creatorcontrib><creatorcontrib>Pépin, Jean-Louis</creatorcontrib><title>Obstructive sleep apnea in patients surviving acute hypercapnic respiratory failure is best predicted by static hyperinflation</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Acute hypercapnic respiratory failure (AHRF) treated with non-invasive ventilation in the ICU is frequently caused by chronic obstructive pulmonary disease (COPD) exacerbations and obesity-hypoventilation syndrome, the latter being most often associated with obstructive sleep apnea. Overlap syndrome (a combination of COPD and obstructive sleep apnea) may represent a major burden in this population, and specific diagnostic pathways are needed to improve its detection early after ICU discharge.
To evaluate whether pulmonary function tests can identify a high probability of obstructive sleep apnea in AHRF survivors and outperform common screening questionnaires to identify the disorder.
Fifty-three patients surviving AHRF (31 males; median age 67 years (interquartile range: 62-74) participated in the study. Anthropometric data were recorded and body plethysmography was performed 15 days after ICU discharge. A sleep study was performed 3 months after ICU discharge.
The apnea-hypopnea index was negatively associated with static hyperinflation as measured by the residual volume to total lung capacity ratio in the % of predicted (coefficient = -0.64; standard error 0.17; 95% CI -0.97 to -0.31; p<0.001). A similar association was observed in COPD patients only: coefficient = -0.65; standard error 0.19; 95% CI -1.03 to -0.26; p = 0.002. Multivariate analysis with penalized maximum likelihood confirmed that the residual volume to total lung capacity ratio was the main contributor for apnea-hypopnea index variance in addition to classic predictors. Screening questionnaires to select patients at risk for sleep-disordered breathing did not perform well.
In AHRF survivors, static hyperinflation is negatively associated with the apnea-hypopnea index in both COPD and non-COPD patients. Measuring static hyperinflation in addition to classic predictors may help to increase the recognition of obstructive sleep apnea as common screening tools are of limited value in this specific population.</description><subject>Airway management</subject><subject>Anthropometry</subject><subject>Apnea</subject><subject>Biology and Life Sciences</subject><subject>Chronic illnesses</subject><subject>Chronic obstructive lung disease</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Complications and side effects</subject><subject>Critical care</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Discharge</subject><subject>Hospitals</subject><subject>Hypertension</subject><subject>Hypoventilation</subject><subject>Identification methods</subject><subject>Lung diseases</subject><subject>Males</subject><subject>Mechanical ventilation</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Multivariate analysis</subject><subject>Obesity</subject><subject>Obstructive lung disease</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physiology</subject><subject>Plethysmography</subject><subject>Population</subject><subject>Pulmonary functions</subject><subject>Research and Analysis Methods</subject><subject>Respiratory failure</subject><subject>Respiratory function</subject><subject>Risk factors</subject><subject>Screening</subject><subject>Sleep</subject><subject>Sleep apnea</subject><subject>Sleep disorders</subject><subject>Standard error</subject><subject>Studies</subject><subject>Ventilation</subject><subject>Ventilators</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk0uL2zAUhU1p6Uyn_QelFRRKu0iqhy1bm8Iw9BEYCPS1FbJ0nWhwLI8kh2bT314l8QxxmUXxwpb8naOrI90se0nwnLCSfLhxg-9UO-9dB3NMccG5eJSdE8HojFPMHp98n2XPQrjBuGAV50-zM4ZZIXKCz7M_yzpEP-hot4BCC9Aj1XegkO1Qr6KFLgYUBr-1W9utkNJDBLTe9eB14qxGHkJvvYrO71CjbDt4QDagGkJEvQdjdQSD6h0KMdnpo9Z2TZtGrnuePWlUG-DF-L7Ifn7-9OPq6-x6-WVxdXk901zQOCuqCigWuKqFqCoGBVN1WeVEEW4MJTlvcN1UdS2oaUqOsU4CWhYlpwZACcMustdH3751QY7RBUkJLajgrBKJWBwJ49SN7L3dKL-TTll5mHB-JZVPG2hBgtbGFAZqQyAvcyyqMpXFC10RToXOk9fHcbWh3oDRKUSv2onp9E9n13LltjKdFakOxbwbDby7HVKUcmODhrZVHbjhUDcXuMhZmdA3_6AP726kViptIMXv0rp6byovi0KUJeN4T80foNJjYGN1umeNTfMTwfuJIDERfseVGkKQi-_f_p9d_pqyb0_YNag2roNrh_2VCVMwP4LauxA8NPchEyz3bXKXhty3iRzbJMlenR7QveiuL9hf7qwPtQ</recordid><startdate>20181025</startdate><enddate>20181025</enddate><creator>Adler, Dan</creator><creator>Dupuis-Lozeron, Elise</creator><creator>Janssens, Jean Paul</creator><creator>Soccal, Paola M</creator><creator>Lador, Frédéric</creator><creator>Brochard, Laurent</creator><creator>Pépin, Jean-Louis</creator><general>Public Library of Science</general><general>Public Library of Science 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sleep apnea in patients surviving acute hypercapnic respiratory failure is best predicted by static hyperinflation</title><author>Adler, Dan ; Dupuis-Lozeron, Elise ; Janssens, Jean Paul ; Soccal, Paola M ; Lador, Frédéric ; Brochard, Laurent ; Pépin, Jean-Louis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-588e20908b99883e53ab7841a16dd2146f0bf8bb92df7600c588275762deea9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Airway management</topic><topic>Anthropometry</topic><topic>Apnea</topic><topic>Biology and Life Sciences</topic><topic>Chronic illnesses</topic><topic>Chronic obstructive lung disease</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Complications and side effects</topic><topic>Critical care</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Discharge</topic><topic>Hospitals</topic><topic>Hypertension</topic><topic>Hypoventilation</topic><topic>Identification methods</topic><topic>Lung diseases</topic><topic>Males</topic><topic>Mechanical ventilation</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Multivariate analysis</topic><topic>Obesity</topic><topic>Obstructive lung disease</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Physiology</topic><topic>Plethysmography</topic><topic>Population</topic><topic>Pulmonary functions</topic><topic>Research and Analysis Methods</topic><topic>Respiratory failure</topic><topic>Respiratory function</topic><topic>Risk factors</topic><topic>Screening</topic><topic>Sleep</topic><topic>Sleep apnea</topic><topic>Sleep disorders</topic><topic>Standard 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one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adler, Dan</au><au>Dupuis-Lozeron, Elise</au><au>Janssens, Jean Paul</au><au>Soccal, Paola M</au><au>Lador, Frédéric</au><au>Brochard, Laurent</au><au>Pépin, Jean-Louis</au><au>Lee, Pei-Lin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Obstructive sleep apnea in patients surviving acute hypercapnic respiratory failure is best predicted by static hyperinflation</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-10-25</date><risdate>2018</risdate><volume>13</volume><issue>10</issue><spage>e0205669</spage><epage>e0205669</epage><pages>e0205669-e0205669</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Acute hypercapnic respiratory failure (AHRF) treated with non-invasive ventilation in the ICU is frequently caused by chronic obstructive pulmonary disease (COPD) exacerbations and obesity-hypoventilation syndrome, the latter being most often associated with obstructive sleep apnea. Overlap syndrome (a combination of COPD and obstructive sleep apnea) may represent a major burden in this population, and specific diagnostic pathways are needed to improve its detection early after ICU discharge.
To evaluate whether pulmonary function tests can identify a high probability of obstructive sleep apnea in AHRF survivors and outperform common screening questionnaires to identify the disorder.
Fifty-three patients surviving AHRF (31 males; median age 67 years (interquartile range: 62-74) participated in the study. Anthropometric data were recorded and body plethysmography was performed 15 days after ICU discharge. A sleep study was performed 3 months after ICU discharge.
The apnea-hypopnea index was negatively associated with static hyperinflation as measured by the residual volume to total lung capacity ratio in the % of predicted (coefficient = -0.64; standard error 0.17; 95% CI -0.97 to -0.31; p<0.001). A similar association was observed in COPD patients only: coefficient = -0.65; standard error 0.19; 95% CI -1.03 to -0.26; p = 0.002. Multivariate analysis with penalized maximum likelihood confirmed that the residual volume to total lung capacity ratio was the main contributor for apnea-hypopnea index variance in addition to classic predictors. Screening questionnaires to select patients at risk for sleep-disordered breathing did not perform well.
In AHRF survivors, static hyperinflation is negatively associated with the apnea-hypopnea index in both COPD and non-COPD patients. Measuring static hyperinflation in addition to classic predictors may help to increase the recognition of obstructive sleep apnea as common screening tools are of limited value in this specific population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30359410</pmid><doi>10.1371/journal.pone.0205669</doi><tpages>e0205669</tpages><orcidid>https://orcid.org/0000-0002-9915-862X</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2018-10, Vol.13 (10), p.e0205669-e0205669 |
| issn | 1932-6203 1932-6203 |
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| source | Public Library of Science (PLoS) Journals Open Access; TestCollectionTL3OpenAccess; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Airway management Anthropometry Apnea Biology and Life Sciences Chronic illnesses Chronic obstructive lung disease Chronic obstructive pulmonary disease Complications and side effects Critical care Diagnosis Diagnostic systems Discharge Hospitals Hypertension Hypoventilation Identification methods Lung diseases Males Mechanical ventilation Medicine Medicine and Health Sciences Multivariate analysis Obesity Obstructive lung disease Patients Physical Sciences Physiology Plethysmography Population Pulmonary functions Research and Analysis Methods Respiratory failure Respiratory function Risk factors Screening Sleep Sleep apnea Sleep disorders Standard error Studies Ventilation Ventilators |
| title | Obstructive sleep apnea in patients surviving acute hypercapnic respiratory failure is best predicted by static hyperinflation |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-27T14%3A25%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Obstructive%20sleep%20apnea%20in%20patients%20surviving%20acute%20hypercapnic%20respiratory%20failure%20is%20best%20predicted%20by%20static%20hyperinflation&rft.jtitle=PloS%20one&rft.au=Adler,%20Dan&rft.date=2018-10-25&rft.volume=13&rft.issue=10&rft.spage=e0205669&rft.epage=e0205669&rft.pages=e0205669-e0205669&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0205669&rft_dat=%3Cgale_plos_%3EA559773609%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2125296389&rft_id=info:pmid/30359410&rft_galeid=A559773609&rft_doaj_id=oai_doaj_org_article_eccdd5debd1e474098799865c81629c4&rfr_iscdi=true |