Trial of BiPAP during Sleep in Chronic Respiratory Failure with hypercapnic

睡眠期间 BiPAP 在伴有高碳酸血症的慢性呼吸衰竭中的试验

• 批准号: 07670677
• 负责人: ABE Tadashi
• 金额: $ 1.47万
• 依托单位: KITASATO UNIVERSITY
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07670677/
• 关键词: Chronic respiratory failuve; Pulse oxymeter; BiPAP; Hypoxia; Oxygen desaturation; 呼吸不全; パルスオキシメーター

Purpose : Some patients with chronic respiratory failure, especially patients with hypercapnia, show severe nocturnal oxygen desaturation. The oxygen desaturation during sleep aggravate the general condition of the patients. The main reason of the oxygen desaturation is believed to be the hypoventilation during sleep. Meanwhile, pressure support ventilator has been ameliorated and bilevel positive airway pressure (BiPAP) system, by which we can expect better tolerance, has become available. We, therefore, tried to elucidate the pathophysiology of nocturnal oxygen desaturation, way of setting of BiPAP and optimal setting of pressures for BiPAP,in order to apply BiPAP properly for patients of chronic respiratory failure with nocturnal oxygen desaturation.Methods : We measured oxygen desaturation during sleep using pulse oxymeter and recorded continuously using a notebook computer in 40 patients with chronic respiatory failure. In 20 patients, measurements were repeated for more than a mo … More nth and the results were compared with the various parameters showing general conditions. Some of the patients showing nocturnal hypoxia were examined using polysomnograph and capnograph in addition to pulse oxymeter. Relations of the sleep stage to the nocturnal oxygen desaturation, ventilation, or end-tidal CO2 were analyzed. BiPAP was applied during sleep to some of the patients with nocturnal oxygen desaturation.Results : Many patients of chronic respiratory failure with daytime PaO2 over 60 torr showed nocturnal oxygen desaturation and some of them were very severe desaturation. Most of the patients showing severe nocturnal desaturation had history of repeated admission for acute exacerbation. Nocturnal oxygen desaturation was worse in REM stage than in non-Rem stage. BiPAP satisfactory prevented nocturnal oxygen desaturation even in REM stage. Repeated trials were necessary to obtain optimal pressures for BiPAP.Conclusion : Prevention of nocturnal oxygen desaturation is important for the patients of chronic respiratory failure and BiPAP satisfactory prevents the nocturnal oxygen desaturation. Less

目的：慢性呼吸衰竭患者，尤其是高碳酸血症患者，夜间氧饱和度下降严重。睡眠时氧饱和度下降加重患者的全身状况。睡眠时的通气不足被认为是氧饱和度下降的主要原因。与此同时，压力支持呼吸机也得到了改进，双水平气道正压通气（BiPAP）系统已成为可能，它可以使患者有更好的耐受性。方法：对40例慢性呼吸衰竭患者采用脉搏血氧仪测定睡眠时的氧饱和度，并在笔记本电脑上连续记录。在20名患者中，重复测量超过一个月， ...更多信息 n，并将结果与显示一般条件的各种参数进行比较。对部分有夜间缺氧表现的患者，除脉搏血氧仪外，还进行了多导睡眠图和二氧化碳监测。分析了睡眠阶段与夜间氧饱和度下降、通气量或潮气末CO2的关系。结果：慢性呼吸衰竭患者白天PaO 2 > 60 μ g/min时，多数患者出现夜间氧饱和度下降，部分患者夜间氧饱和度下降程度较重。大多数出现严重夜间血氧饱和度下降的患者有因急性加重而反复入院的病史。REM期夜间氧饱和度下降较非REM期严重。即使在REM阶段，BiPAP也能令人满意地防止夜间氧饱和度下降。结论：预防慢性呼吸衰竭患者夜间氧饱和度下降是非常重要的，BiPAP可有效预防夜间氧饱和度下降。少