The effect of CPAP treatment on venous lactate and arterial blood gas among obstructive sleep apnea syndrome patients
The effect of CPAP treatment on venous lactate and arterial blood gas among obstructive sleep apnea syndrome patients
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CPAP治疗对阻塞性睡眠呼吸暂停综合征患者静脉乳酸和动脉血气的影响
DOI：
10.1007/s11325-016-1409-x
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发表时间：
2017-05
期刊：
影响因子：
--
通讯作者：
Qi JC
中科院分区：
文献类型：
--
作者：
Lin T;Huang JF;Lin QC;Chen GP;Wang BY;Zhao JM;Qi JC
目的观察持续气道正压通气（CPAP）对阻塞性睡眠呼吸暂停综合征（OSAS）患者动脉血气和静脉血乳酸（组织缺氧标志物）的影响，探讨OSAS患者血乳酸和氢离子浓度（PH）的危险因素。所有患者均接受CPAP治疗一晚。结果109例受试者的平均乳酸水平为2.23 ± 0.59 mmol/L，平均PH值为7.380 ± 0.23，平均PaO 2为88.14 ± 17.83 mmHg，平均PaCO 2为88.14 ± 17.83 mmHg。38.70 ± 4.28mmHg。与治疗前相比，CPAP治疗后乳酸显著降低（2.10 ± 0.50mmol/L，p= 0.03），PH显著升高（7.388 ± 0.27，p < 0.05）。此外，颈围、睡眠呼吸暂停低通气指数、血氧饱和度下降指数（ODI）、平均血氧饱和度（SpO 2）、SpO 2 <90%的睡眠时间百分比（TS90%）与乳酸呈正相关，年龄与乳酸呈负相关（均P < 0.05）。年龄、颈围和PH之间存在显著正相关;此外，ODI和PH之间存在负相关。最后，在调整混杂因素后，TS90%是乳酸升高的主要预测因子（p< 0.05），年龄是PH值升高的预测因子结论CPAP治疗可降低OSAS患者的血乳酸，升高PH值，对缓解OSAS患者的酸碱平衡紊乱有一定作用。此外，TS90%是乳酸升高的危险因素，年龄与PH独立相关。
PurposeThe aim of this observational study was to investigate the influence of continuous positive airway pressure (CPAP) on arterial blood gas and venous lactate, markers of tissue hypoxia, among obstructive sleep apnea syndrome (OSAS) patients, and determine the risk factor of serum lactate and hydrogen ion concentration (PH) in OSAS patients.Materials and methodsOne-hundred and nine patients with newly diagnosed OSAS were enrolled in the study. All individuals were treated with CPAP for one night. Venous lactate and arterial blood gas were gathered from all subjects in the morning at the end of polysomnography and the next morning after CPAP treatment.ResultsOf the 109 selected subjects, the average lactate level was 2.23 ± 0.59 mmol/L, and the mean PH, PaO2, and PaCO2were 7.380 ± 0.23, 88.14 ± 17.83 mmHg, and 38.70 ± 4.28 mmHg, respectively. Compared to baseline, lactic acid significantly decreased (2.10 ± 0.50 mmol/L,p= 0.03), while PH increased (7.388 ± 0.27,p< 0.05) after CPAP treatment. In addition, neck circumference and the polysomnographic parameters, including apnea-hypopnea index, oxygen desaturation index (ODI), mean oxygen saturation (SpO2), and the percentage of sleep time with SpO2<90 % (TS90 %), positively correlated with lactate, while age correlated negatively with lactate (allp< 0.05). Significantly positive associations were found between age, neck circumference, and PH; furthermore, a negative correlation was found between ODI and PH. Finally, after adjusting for confounding factors, TS90 % was the major contributing predictor for elevated lactate (p< 0.05), and age was a predictor for an increase in PH (p< 0.05).ConclusionsThe results indicated that CPAP treatment could reduce serum lactate and increase PH in OSAS patients and might alleviate acid-base balance disorders in OSAS. Furthermore, TS90 % was a risk factor for elevated lactate, and age was independently associated with PH.
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DOI：
10.1186/cc1518
发表时间：
2002-08
期刊：
Critical care (London, England)
影响因子：
--
作者：
Bellomo R
通讯作者：
Bellomo R
影响因子：
5.6
作者：
B. Cooper;J. White;L. Ashworth;K. Alberti;G. Gibson
通讯作者：
B. Cooper;J. White;L. Ashworth;K. Alberti;G. Gibson
影响因子：
6.2
作者：
M. Graber
通讯作者：
M. Graber
DOI：
10.1183/09031936.98.12030658
发表时间：
1998-09
期刊：
The European respiratory journal
影响因子：
--
作者：
C. Pison;C. Chauvin;H. Perrault;C. Schwebel;J. Lafond;C. Boujet;X. Leverve
通讯作者：
C. Pison;C. Chauvin;H. Perrault;C. Schwebel;J. Lafond;C. Boujet;X. Leverve
影响因子：
158.5
作者：
YOUNG, T;PALTA, M;BADR, S
通讯作者：
BADR, S