• Resp Care · Feb 2012

    Sleep-disordered breathing may be under-recognized in patients who wean from prolonged mechanical ventilation.

    • Avelino C Verceles, Steven M Scharf, Montserrat Diaz-Abad, and John E Brown.
    • University of Maryland School of Medicine, Baltimore, MD, USA. mdiaz@medicine.umaryland.edu
    • Resp Care. 2012 Feb 1;57(2):229-37.

    BackgroundThe prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV.MethodsRetrospective chart review was conducted of all PMV patients who had in-patient polysomnography (PSG) between January 2007 and May 2010. Main outcome measures included the frequency of SDB and tracheostomy decannulation.ResultsNineteen patients were studied, age 53.4 ± 13.4 years, 11 males (57.9%), with mean body mass index of 44.0 ± 12.7 kg/m(2) (range 27.3-75.7). Eighteen patients (94.7%) demonstrated SDB as evidenced by obstructive sleep apnea (OSA), with a median respiratory disturbance index (RDI) of 24.2 events/h (range 5.9-82.0 events/h). Fourteen patients underwent successful positive airway pressure titration, with improvement in the median RDI to 0.9 events/h (range 0.0-9.1 events/h) (P < .001). Seventeen patients (89.5%) were decannulated without adverse event.ConclusionsThere may be a high prevalence of unrecognized SDB in patients who are candidates for decannulation after weaning from PMV.

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