Concerning the sleep curriculum in a pulmonary training program.
Concerning the sleep curriculum in a pulmonary training program.
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关于肺训练计划中的睡眠课程。
DOI：
10.1007/s11325-001-0053-1
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
Strohl,KP
中科院分区：
文献类型：
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作者：
Strohl,KP
下载此文件仅供个人使用。严禁未经授权分发。睡眠呼吸障碍是神经肌肉疾病、慢性阻塞性肺病和其他心肺疾病的合并症；(2)日间过度嗜睡的鉴别诊断。1992年，两家机构都将解读长期心肺监测和理解解读多导睡眠图（PSG）报告的能力列为“技能”。心肺监测是指对研究的解释，包括但不限于呼吸力、呼吸气流、心脏测量或气体交换测量（动脉血气或无创氧饱和度测量、经皮测量或潮末二氧化碳测量）。假设对脑电图（EEG）程序的了解以及对脑电图睡眠或多次睡眠潜伏期试验（MSLT）的任何解释或报告都将被理解为肺病医生可以为他或她的病人做出最好的决定。换句话说，虽然实习生或肺病专家不需要对PSG或MSLT进行评分，但他或她应该知道在解释PSG或MSLT时应该寻找什么，以确定医生报告和建议的有效性。随着时间的推移，心肺监测的测量已经被认为是培训课程的一部分，因为它们与重症监护病房的心肺病理生理学以及肺部医学门诊实践直接相关。我相信，这些测试可以由肺科医生或重症监护医生在不进行直接睡眠测量的情况下进行解释。它们应该被解释为这些测量如何影响病人护理中可能遇到的疾病的诊断、治疗和随访，以及睡眠问题是问题的后果而不是原因。这样的环境可能包括重症监护病房或睡眠呼吸暂停的管理，这是一种与睡眠有关的呼吸控制系统的不稳定。医生应该能够“回头看”PSG，并询问有关心肺测量异常的原因和干预效果的相关问题。我的结论是，随着时间的推移，这些知识和学习目标以及肺医学实践领域中关于呼吸障碍睡眠管理的技能的清晰性已经丧失。
This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. sleep-disordered breathing as a comorbidity in neuromuscular disease, COPD, and other cardiopulmonary disorders;(2) the differential diagnosis of excessive daytime sleepiness. In 1992, both agencies listed as “skills” the interpretation of cardiopulmonary monitoring over time and the ability to understand the interpretation of polysomnographic (PSG) reports. Cardiopulmonary monitoring referred to the interpretation of studies, including but not limited to respiratory effort, respiratory airflow, cardiac measures or measurements of gas exchange (arterial blood gases or noninvasive measures of oxygen saturation, transcutaneous measures, or end-tidal CO2). It was assumed that knowledge of electroencephalographic (EEG) procedures and any interpretation or report about EEG sleep or the multiple sleep latency test (MSLT) would be understood to the point that the pulmonary practitioner could make the best decision for his or her patient. In other words, whereas the trainee or pulmonary specialist would not be expected to score the PSG or MSLT, he or she should know what to look for in an interpretation of a PSG or MSLT to determine the validity of the physician report and recommendations. Measurements of cardiopulmonary monitoring over time have been acknowledged as a part of the training curriculum because they are directly relevant to cardiorespiratory pathophysiology in the intensive care unit as well as in the outpatient practice of pulmonary medicine. Such tests, I believe, can be interpreted without performing direct measurements of sleep by a pulmonologist or critical care practitioner. They should be interpreted in terms of how these measurements impact the diagnosis, treatment, and follow-up of diseases likely to be encountered in patient care and when sleep problems are the consequence rather than the cause of the problem. Such settings might include the intensive care unit or the management of sleep apnea, an instability of the respiratory control system that is sleep related. The physician should be able to “look over the shoulder” at a PSG and ask pertinent questions about the reasons for abnormalities in cardiopulmonary measurements and the effect of interventions. I conclude that over time there has been a loss of articulation of this knowledge and learning objectives as well as the skills that are well within the domain of practice of pulmonary medicine in regard to the management of breathing-disturbed sleep.