Background An apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death. Methods On ...Background An apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death. Methods On 93 adult patients in coma in Zhejiang Province of China from January 2003 to December 2006, 179 apnea tests were performed as a part of the determination of brain death. Potential risk conditions and complications were analysed during apnea tests. Results During apnea, serious cardiac arrhythmia did not occur in all patients. Complications occurred in 37 of 179 (21%) apnea tests. Hypotension occurred in 30 patients (17%) and it was observed in 8/94 (9%) tests with baseline value of systolic arterial blood pressure not less than 120 mmHg, and 22/85 (26%) less than 120 mmHg (P 〈0.05). Severe hypoxaemia occurred in 10 patients (6%) of which 3/138 (2%) tests with baseline value of arterial oxygen pressure not less than 200 mmHg, and 7/41 (17%) less than 200 mmHg (P 〈0.05). Conclusions This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation. Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.展开更多
Objective: Obstructive sleep apnea-hypopnea syndrome (OSA) is a disease of obstructive apnea or hypopnea caused by a repeated partial or complete collapse of the upper airway during sleep. The inspiratory part of the ...Objective: Obstructive sleep apnea-hypopnea syndrome (OSA) is a disease of obstructive apnea or hypopnea caused by a repeated partial or complete collapse of the upper airway during sleep. The inspiratory part of the flow-volume curve (F-V curve) can be used as an auxiliary means to evaluate upper airway obstruction in adults. This study is to evaluate the ability of the F-V curve to predict the OSA and explore inspiratory indicators related to airway obstruction during sleep. Methods: There were 332 patients included in this cross-sectional study, who were accompanied by snoring, daytime sleepiness and other symptoms, with suspicion of OSA. According to the nocturnal polysomnography, the subjects were distributed into mild to moderate OSA group, severe OSA group and non-OSA group. A pulmonary function test was used to collect the subjects’ spirometry and F-V curves. Results: There was no significant difference in a variety of indices derived from the F-V curve between OSA and normal subjects, including 25% inspiratory flow rate, middle inspiratory flow rate, 75% inspiratory flow rate, peak flow rate, and forced inspiratory flow rate in the first second. The pulmonary function parameters were significantly correlated with the weight, age and sex of the subjects. Conclusion: These findings suggest that the inspiratory curve of pulmonary function cannot evaluate the upper airway abnormalities in patients with obstructive apnea-hypopnea syndrome.展开更多
文摘Background An apnea test is essential in the clinical determination of brain death. This study was conducted to analyse complications associated with the apnea test in the determination of the brain death. Methods On 93 adult patients in coma in Zhejiang Province of China from January 2003 to December 2006, 179 apnea tests were performed as a part of the determination of brain death. Potential risk conditions and complications were analysed during apnea tests. Results During apnea, serious cardiac arrhythmia did not occur in all patients. Complications occurred in 37 of 179 (21%) apnea tests. Hypotension occurred in 30 patients (17%) and it was observed in 8/94 (9%) tests with baseline value of systolic arterial blood pressure not less than 120 mmHg, and 22/85 (26%) less than 120 mmHg (P 〈0.05). Severe hypoxaemia occurred in 10 patients (6%) of which 3/138 (2%) tests with baseline value of arterial oxygen pressure not less than 200 mmHg, and 7/41 (17%) less than 200 mmHg (P 〈0.05). Conclusions This study demonstrated that complications occurred mostly in patients with inadequate baseline systolic arterial blood pressure and preoxygenation. Adequate precautions during the apnea tests may reduce the risk of cardiovascular and oxygenation complication.
文摘Objective: Obstructive sleep apnea-hypopnea syndrome (OSA) is a disease of obstructive apnea or hypopnea caused by a repeated partial or complete collapse of the upper airway during sleep. The inspiratory part of the flow-volume curve (F-V curve) can be used as an auxiliary means to evaluate upper airway obstruction in adults. This study is to evaluate the ability of the F-V curve to predict the OSA and explore inspiratory indicators related to airway obstruction during sleep. Methods: There were 332 patients included in this cross-sectional study, who were accompanied by snoring, daytime sleepiness and other symptoms, with suspicion of OSA. According to the nocturnal polysomnography, the subjects were distributed into mild to moderate OSA group, severe OSA group and non-OSA group. A pulmonary function test was used to collect the subjects’ spirometry and F-V curves. Results: There was no significant difference in a variety of indices derived from the F-V curve between OSA and normal subjects, including 25% inspiratory flow rate, middle inspiratory flow rate, 75% inspiratory flow rate, peak flow rate, and forced inspiratory flow rate in the first second. The pulmonary function parameters were significantly correlated with the weight, age and sex of the subjects. Conclusion: These findings suggest that the inspiratory curve of pulmonary function cannot evaluate the upper airway abnormalities in patients with obstructive apnea-hypopnea syndrome.