Nocturnal hypoventilation in neuromuscular disease: prevalence according to different definitions issued from the literature
| العنوان: | Nocturnal hypoventilation in neuromuscular disease: prevalence according to different definitions issued from the literature |
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| المؤلفون: | Ghassane Mroue, Isabelle Vaugier, Adam Ogna, David Orlikowski, Djillali Annane, Hélène Prigent, Maria-Antonia Quera Salva, Frédéric Lofaso |
| المصدر: | Sleep and Breathing. 20:575-581 |
| بيانات النشر: | Springer Science and Business Media LLC, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Adult, Male, Pediatrics, medicine.medical_specialty, Neuromuscular disease, medicine.medical_treatment, Concordance, Population, 03 medical and health sciences, 0302 clinical medicine, Oxygen therapy, medicine, Humans, Oximetry, education, Retrospective Studies, Acid-Base Equilibrium, Mechanical ventilation, education.field_of_study, business.industry, Hypoventilation, Neuromuscular Diseases, Middle Aged, medicine.disease, Circadian Rhythm, Cross-Sectional Studies, 030228 respiratory system, Otorhinolaryngology, Respiratory failure, Female, Neurology (clinical), medicine.symptom, Respiratory Insufficiency, business, Blood Gas Monitoring, Transcutaneous, Hypercapnia, 030217 neurology & neurosurgery |
| الوصف: | Restrictive respiratory failure is a major cause of morbidity and mortality in neuromuscular diseases (NMD). Home mechanical ventilation (HMV) is used to treat hypoventilation, identified by daytime hypercapnia or nocturnal desaturation. Recently, transcutaneous measure of CO2 (TcCO2) has been increasingly used to detect hypoventilation, using different cut-offs. We aimed to compare the prevalence of hypoventilation in an unselected adult NMD population according to different definitions issued from the literature. All consecutive nocturnal capno-oximetries performed between 2010 and 2014 in unventilated adult NMD patients were analysed retrospectively. Concomitant blood gas analysis and lung function data were collected. Patients on oxygen therapy were excluded. Hypoventilation was defined according to eight criteria, based on daytime PaCO2, daytime base excess, nocturnal SpO2 or TcCO2. Data from 232 patients were analysed (mean age 43.1 ± 15.4 years; 50.0 % women; vital capacity 59.2 ± 24.2 % of predicted). The hypoventilation prevalence was 10.3 to 61.2 %, depending on the used definition. The different definitions showed 49.1 to 94.8 % concordance (Cohen’s kappa for agreement 0.115 to 0.763). Overall agreement between the eight definitions was poor (Light’s kappa 0.267), and agreement between definitions based on nocturnal SpO2 and those based on TcCO2 was even lower (Light’s kappa 0.204). We found large differences in hypoventilation prevalence according to the used definition. This has practical consequences, as HMV indication relies upon hypoventilation detection. We believe that capno-oximetry should be included in the diagnostic tools used to detect hypoventilation but this requires an update of consensus guidelines to agree upon the best definition. |
| تدمد: | 1522-1709 1520-9512 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8809fe080f2fde651150efe5e587acdbTest https://doi.org/10.1007/s11325-015-1247-2Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....8809fe080f2fde651150efe5e587acdb |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15221709 15209512 |
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