• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>JAMA otolaryngology-- head & neck surgery >Evaluation of Therapeutic Positive Airway Pressure as a Hypoglossal Nerve Stimulation Predictor in Patients With Obstructive Sleep Apnea
【24h】

Evaluation of Therapeutic Positive Airway Pressure as a Hypoglossal Nerve Stimulation Predictor in Patients With Obstructive Sleep Apnea

机译：梗阻性睡眠呼吸暂停患者中疗效正气道压力评价治疗阳性气道压力

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Importance Recent retrospective hypoglossal nerve stimulation (HGNS) outcomes data suggest that patients with low therapeutic positive airway pressure (PAP) levels achieve greater success than patients with high therapeutic PAP levels. Objective To examine the use of therapeutic nasal PAP levels at the soft palate in predicting the outcomes of HGNS for patients with obstructive sleep apnea. Design, Setting, and Participants This prospective cohort study used drug-induced sleep endoscopy (DISE) to evaluate the predictive capacity of therapeutic PAP levels in HGNS outcomes. In an academic sleep surgery center, 27 consecutive patients with obstructive sleep apnea who underwent DISE before implantation of an HGNS device were evaluated. The study was conducted from May 1, 2018, to June 26, 2019. Exposures Positive airway pressure delivered through a nasal mask during DISE. Main Outcomes and Measures Improvement in apnea-hypopnea index as measured from full-night preoperative and postoperative efficacy studies. Results Twenty-seven patients met all inclusion criteria. The mean (SD) age was 62.0 (14.4) years, 14 participants were men (51.9%), and mean body mass index was 28.1 (4.0). Responders to HGNS therapy (n = 18) had significantly lower mean (SD) palatal opening pressure compared with nonresponders (n = 9) (5.0 [2.8] vs 9.2 [3.7] cm H2O, respectively; mean difference, -4.2; 95% CI, -6.8 to -1.6 cm H2O). After adjusting for age, sex, and body mass index, the mean palatal opening pressure value for the responders remained 3.5 cm H2O lower (95% CI, -6.7 to -0.4 cm H2O) than that of nonresponders. A palatal opening pressure cutoff level less than 8 cm H2O demonstrated a positive predictive value of 82.4%; sensitivity, 77.8%; and specificity, 66.7%. Conclusions and Relevance In this small prospective cohort study, therapeutic nasal PAP levels during DISE differed significantly between responder and nonresponders to HGNS. Because DISE represents a mandatory, relatively standardized diagnostic tool for HGNS candidacy, the use of therapeutic nasal PAP through DISE can be broadly implemented and studied across multiple centers to possibly improve patient selection for HGNS.
机译：重要性近期回顾性低压神经刺激（HGNS）结果数据表明，治疗阳性气道压力低（PAP）水平低的患者比高治疗性PAP水平的患者取得更大的成功。目的探讨软腭下治疗性鼻腔PAP水平的用途，以预测阻塞性睡眠呼吸暂停患者HGN的结果。设计，设定和参与者该潜在的队列研究使用药物诱导的睡眠内窥镜检查（丧失）来评估HGNS结果中治疗性PAP水平的预测能力。在学术睡眠手术中心，评估了27例连续27名患有在植入HGNS装置之前进行疾病的阻塞性睡眠呼吸暂停患者。该研究于2018年5月1日至2019年6月26日开始进行。在丧失期间，通过鼻面膜曝光正气道压力。呼吸暂停术前和术后疗效研究中呼吸暂停症指数的主要结果及措施改善。结果二十七名患者达到了所有纳入标准。平均值（SD）年龄为62.0（14.4）岁，14名参与者是男性（51.9％），平均体重指数为28.1（4.0）。与非反应者（n = 9）相比，响应者对HGNS治疗（n = 18）的响应者（n = 18）显着降低平均值（SD）腭开启压力（5.0 [2.8] Cm H 2 O;平均差异，-4.2; 95％ CI，-6.8至-1.6厘米H2O）。调整年龄，性别和体重指数后，响应者的平均腭打开压力值持续3.5cm H 2 O降（95％CI，-6.7至-0.4cm H 2 O）。腭开口压力截止水平小于8cm H2O，证明了82.4％的阳性预测值;敏感度，77.8％;和特异性，66.7％。在这个小型前瞻性队列研究中的结论和相关性，丧失症期间的治疗性鼻腔PAP水平显着不同于HGNS之间的响应性和无关。由于丧失涉及HGNS候选的强制性相对明确的诊断工具，因此可以在多个中心广泛地实施并研究通过丧失治疗治疗性鼻腔的使用，以改善HGN的患者选择。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号