Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation.
Introduction: Self-adjusting titration (APAP) at home is accepted to define therapeutic pressure (CPAPT). The APAP device report may be insufficient to ensure adequate therapeutic response in all patients. There is no consensus on the use of oximetry during APAP titration. Objective: To evaluate the...
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2025
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/44671 |
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I10-R327-article-44671 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
sleep apnea obstructive hypoxia continuous positive airway pressure apnea obstructiva del sueño hipoxia presión de las vías aéreas positiva continua apneia obstrutiva do sono hipóxia pressão positiva continua nas vias aéreas |
| spellingShingle |
sleep apnea obstructive hypoxia continuous positive airway pressure apnea obstructiva del sueño hipoxia presión de las vías aéreas positiva continua apneia obstrutiva do sono hipóxia pressão positiva continua nas vias aéreas Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| topic_facet |
sleep apnea obstructive hypoxia continuous positive airway pressure apnea obstructiva del sueño hipoxia presión de las vías aéreas positiva continua apneia obstrutiva do sono hipóxia pressão positiva continua nas vias aéreas |
| author |
Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo |
| author_facet |
Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo |
| author_sort |
Franzoy, Julieta |
| title |
Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| title_short |
Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| title_full |
Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| title_fullStr |
Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| title_full_unstemmed |
Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. |
| title_sort |
residual hypoxemia during titration with self-adjusting cpap at home in patients without prior adaptation. |
| description |
Introduction: Self-adjusting titration (APAP) at home is accepted to define therapeutic pressure (CPAPT). The APAP device report may be insufficient to ensure adequate therapeutic response in all patients. There is no consensus on the use of oximetry during APAP titration.
Objective: To evaluate the prevalence and magnitude of residual hypoxemia (RH) in titration with APAP not monitored at home and to identify related variables.
Materials and Methods: Retrospective study based on APAP titrations with coupled oximetry, arterial blood gases and spirometry test. A T90 > 10% of the night was considered significant RH. Predictors of HR were identified by logistic regression (RL).
Results: 116 cases were included. 41% in the group with RH. These were older (66.7 vs. 59.6 years, p: 0.02), lower absolute FEV1 (2.17 vs. 2.57 liters, p: 0.06), lower absolute FVC (2.9 vs. 3.3 liters, p: 0.02) and lower basal PO2 (77.3 vs. 84.2 mmHg, p: 0.04). The titration period reached 3.6 ± 1 nights, average adherence of 374 ± 88.4 minutes/night; CPAPT (cm H2O): 9.4 ± 1.8, AHIr; 3.1 ± 3.2 ev/h and leaks (liters/min): 19.7 ± 11.2. Multiple logistic regression identified age > 66 years as a predictor of RH (OR 3.32, 95% CI 1.43 - 7.69, p: 0.005) and FEV1 < 1.76 liters (OR 3.29 – IC95% 1.27 – 8.53, p: 0.0139).
Conclusions: Incompletely corrected nocturnal oximetry was observed in a significant proportion of patients with APAP. Age over 66 years and absolute FEV1 < 1.76 liters were correlated with residual hypoxemia. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2025 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/44671 |
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I10-R327-article-446712025-03-31T17:43:08Z Residual hypoxemia during titration with self-adjusting CPAP at home in patients without prior adaptation. Hipoxemia residual durante la titulación con CPAP autoajustable en domicilio en pacientes sin adaptación previa Hipoxemia residual durante titulação com CPAP autoajustável em domicilio em pacientes sem adaptação prévia. Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo Franzoy, Julieta Blanco, Magali Ernst, Glenda Ginetti, Maria Belen Perri, Marcella Borsini, Eduardo sleep apnea obstructive hypoxia continuous positive airway pressure apnea obstructiva del sueño hipoxia presión de las vías aéreas positiva continua apneia obstrutiva do sono hipóxia pressão positiva continua nas vias aéreas Introduction: Self-adjusting titration (APAP) at home is accepted to define therapeutic pressure (CPAPT). The APAP device report may be insufficient to ensure adequate therapeutic response in all patients. There is no consensus on the use of oximetry during APAP titration. Objective: To evaluate the prevalence and magnitude of residual hypoxemia (RH) in titration with APAP not monitored at home and to identify related variables. Materials and Methods: Retrospective study based on APAP titrations with coupled oximetry, arterial blood gases and spirometry test. A T90 > 10% of the night was considered significant RH. Predictors of HR were identified by logistic regression (RL). Results: 116 cases were included. 41% in the group with RH. These were older (66.7 vs. 59.6 years, p: 0.02), lower absolute FEV1 (2.17 vs. 2.57 liters, p: 0.06), lower absolute FVC (2.9 vs. 3.3 liters, p: 0.02) and lower basal PO2 (77.3 vs. 84.2 mmHg, p: 0.04). The titration period reached 3.6 ± 1 nights, average adherence of 374 ± 88.4 minutes/night; CPAPT (cm H2O): 9.4 ± 1.8, AHIr; 3.1 ± 3.2 ev/h and leaks (liters/min): 19.7 ± 11.2. Multiple logistic regression identified age > 66 years as a predictor of RH (OR 3.32, 95% CI 1.43 - 7.69, p: 0.005) and FEV1 < 1.76 liters (OR 3.29 – IC95% 1.27 – 8.53, p: 0.0139). Conclusions: Incompletely corrected nocturnal oximetry was observed in a significant proportion of patients with APAP. Age over 66 years and absolute FEV1 < 1.76 liters were correlated with residual hypoxemia. Introducción: La titulación autoajustable (APAP) en domicilio es aceptada para definir presión terapéutica (CPAPT). La información obtenida desde el APAP puede ser insuficiente para asegurar adecuada respuesta terapéutica en todos los pacientes. No existe consenso sobre el uso de oximetría durante la titulación con APAP. Objetivo: Evaluar prevalencia y magnitud de la hipoxemia residual (HR) en la titulación con APAP no vigilada en domicilio e identificar variables relacionadas. Materiales y Métodos: Estudio retrospectivo basado en titulaciones de APAP con oximetría acoplada, gases en sangre arterial y espirometría. Un T90 > de 10% de la noche se consideró HR significativa. Se identificaron predictores de HR por regresión logística (RL) Resultados: Incluimos 116 casos. 41% pertenecieron al grupo con HR. Estos tuvieron mayor edad (66.7 vs. 59.6 años, p: 0.02), menor VEF1 absoluto (2.17 vs. 2.57 litros, p: 0.06), menor CVF absoluta (2.9 vs. 3.3 litros, p: 0.02) y menor PO2 basal (77.3 vs. 84.2 mmHg, p: 0.04). El periodo de titulación alcanzó 3.6 ± 1 noches, adherencia media de 374 ± 88.4 minutos/noche; CPAPT (cm H2O): 9.4 ± 1.8, IAHr; 3.1 ± 3.2 ev/h y fugas (litros/min): 19.7 ± 11.2. Fueron predictores de HR; edad > 66 años (OR 3.32, IC95% 1.43 - 7.69, p: 0.005) y el VEF1 < 1.76 litros (OR 3.29 – IC95% 1.27 – 8.53, p: 0.0139). Conclusiones: Una significativa proporción de pacientes que titulan con APAP corrigen incompletamente la oximetría nocturna. La edad > 66 años y el VEF1 absoluto < 1.76 litros se correlacionaron con hipoxemia residual. Introdução: A titulação auto ajustável (APAP) em domicílio é aceita para definir a pressão terapêutica (CPAP). O informe do dispositivo APAP pode ser insuficiente para assegurar adequada resposta terapêutica em todos os pacientes. Não existe consenso sobre oximetria durante a titulação com APAP. Objetivo: Avaliar prevalência e magnitude da hipoxemia residual (HR) na titulação com APAP não vigiada em domicílio e variáveis relacionadas. Materiais e métodos: Estudo retrospectivo baseado em titulações de APAP com oximetria acoplada, gases em sangue arterial e espirometria. Um T90 > de 10% à noite foi considerado HR significativo. Os preditores de HR foram identificados por regressão logística (RL). Resultados: Foram incluídos 116 casos. 41% no grupo com HR. Esses tiveram maior idade (66.7 vs. 59.6 anos, p:0.02) e menor PO2 basal (77.3 vs 84.2 mmHg, p: 0.04). O período de titulação alcançou 3.6 ± 1 noites, aderência média de 374 ± 88.4 minutos/noite; CPAPT (cm H2O): 9.4 ± 1.8, IAHr; 3.1 ± 3.2 ev/h e fugas (litros/min): 19.7 ± 11.2. A RL identificou como preditor a idade > 66 anos (OR 3.32, IC95% 1.43 - 7.69, p: 0.005) e VEF1 absoluto < 1.76 litros (OR 3.29 – IC95% 1.27 – 8.53, p: 0.0139). Conclusões: Uma significativa proporção de pacientes que titulam com APAP corrigem incompletamente a oximetria noturna. Idade acima de 66 anos e VEF1 absoluto < 1.76 litros foram correlacionados com hipoxemia residual. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2025-03-31 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/44671 10.31053/1853.0605.v82.n1.44671 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 82 No. 1 (2025); 61-77 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 82 Núm. 1 (2025); 61-77 Revista da Faculdade de Ciências Médicas de Córdoba; v. 82 n. 1 (2025); 61-77 1853-0605 0014-6722 10.31053/1853.0605.v82.n1 spa https://revistas.unc.edu.ar/index.php/med/article/view/44671/48667 https://revistas.unc.edu.ar/index.php/med/article/view/44671/48624 Derechos de autor 2025 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0 |