Document Detail

Hypercapnia in overlap syndrome: possible determinant factors.
MedLine Citation:
PMID:  11917259     Owner:  NLM     Status:  MEDLINE    
We retrospectively evaluated data from 213 consecutive patients; 152 were affected by obstructive sleep apnea (OSA), 29 had OSA associated with chronic obstructive pulmonary disease (COPD), also known as overlap syndrome, and 32 had COPD. Patients with obesity-hypoventilation syndrome were not included. The aims of the study were to evaluate the anthropometric, pulmonary, and polysomnographic characteristics of patients affected by overlap syndrome compared to "simple" OSA and to COPD subjects and to analyze the determinants of hypercapnia in overlap syndrome. In the comparison between overlap and OSA patients, the overlap group had a significantly higher PaCO2 (44.59 vs. 39.22 mm Hg; p < 0.01), in the presence of a similar AHI (40.46 vs. 41.59/h). Comparing overlap to COPD patients, overlap showed a significantly higher PaCO2 value (44.59 vs. 39.63 mm Hg; p < 0.005) and had significantly less severe obstructive impairment (FEV 162.93 vs. 47.31%; FEV1/FVC ratio 66.71 vs. 59.25%; p < 0.005). Anthropometric, pulmonary function, and polysomnographic data did not differ between normo- and hypercapnic overlap patients. The best model (stepwise multiple regression analysis) for predicting PaCO2 in overlap patients showed r2 value 0.65: PaO2 contributed to 38%, FEV1 to 15%, and weight to 12%. In conclusion, the occurrence of hypercapnia in overlap patients is only partially explained by the combination of overweight and reduced respiratory function, supporting the hypothesis of a multifactorial genesis.
Onofrio Resta; Maria Pia Foschino Barbaro; Caterina Brindicci; Maria Cristina Nocerino; Gennaro Caratozzolo; Monica Carbonara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Sleep & breathing = Schlaf & Atmung     Volume:  6     ISSN:  1520-9512     ISO Abbreviation:  Sleep Breath     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-27     Completed Date:  2002-07-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9804161     Medline TA:  Sleep Breath     Country:  United States    
Other Details:
Languages:  eng     Pagination:  11-8     Citation Subset:  IM    
Department of Clinical Methodology and Medical Surgery Technology, Centre of Sleep Breathing Disorders, University of Bari, Bari, Italy.
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MeSH Terms
Analysis of Variance
Blood Gas Analysis
Hypercapnia / blood,  diagnosis*,  etiology*
Hypoventilation / blood,  complications,  diagnosis
Obesity / complications
Pulmonary Disease, Chronic Obstructive / blood,  complications*
Retrospective Studies
Sleep Apnea, Obstructive / blood,  complications*

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