Document Detail


Relationship between critical pressure and volume exhaled during negative pressure in awake subjects with sleep-disordered breathing.
MedLine Citation:
PMID:  20139226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Critical pressure (Pcrit) is considered a reliable parameter to evaluate the mechanical properties of the passive upper airway (UA) and is significantly increased in patients with obstructive sleep apnea-hypopnea (OSAH) compared with normal subjects. The volume exhaled in the first 0.5 s after application at the mouth of 5 cm H(2)O negative pressure at the onset of expiration (V,NEP(0.5)) during wakefulness has been used as a marker of UA collapsibility. The aim of this study was to investigate if there is a significant relationship between V,NEP(0.5) and Pcrit in normal subjects, snorers, and patients with OSAH. METHODS: Thirty men, 10 with OSAH (aged 64 +/- 9.1 years, BMI 32 +/- 4.9 kg/m(2), apnea-hypopnea index [AHI] 43.8 +/- 24, neck circumference 46.6 +/- 3.7 cm), 10 snorers (aged 68 +/- 11 years, BMI 26.6 +/- 4.6 kg/m(2), AHI 3.5 +/- 0.8, snoring time > or = 30% of sleep time, neck circumference 42.2 +/- 3.9 cm), and 10 controls (aged 67 +/- 12 years, BMI 25.4 +/- 2.2 kg/m(2), AHI 1.9 +/- 1.2, neck circumference 41.2 +/- 2.2 cm) underwent V,NEP(0.5) measurement in supine position while awake and Pcrit measurement during sleep. Correlation between V,NEP(0.5) and Pcrit was performed in all subjects. RESULTS: Controls had V,NEP(0.5) of 456 +/- 82 mL and Pcrit of -1.38 +/- 0.6 cm H(2)O, snorers had V,NEP(0.5) of 321 +/- 33 mL and Pcrit -0.55 +/- 0.3 cm H(2)O, and patients with OSAH showed V,NEP(0.5) of 295 +/- 67 mL and Pcrit of 0.99 +/- 1 cm H(2)O (P < .001 vs normal subjects). A strong correlation was found between V,NEP(0.5) and Pcrit (r(2) = 0.61, P < .0001). CONCLUSIONS: In males with neck circumference > 37 cm, V,NEP(0.5) during wakefulness strongly reflects Pcrit in a wide range of values. Our findings suggest that V,NEP(0.5) can be used as valuable substitute for Pcrit to assess UA collapsibility for clinical and research purposes in these subjects.
Authors:
Luigi Taranto Montemurro; Michela Bettinzoli; Luciano Corda; Alessia Braghini; Claudio Tantucci
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Publication Detail:
Type:  Journal Article     Date:  2010-02-05
Journal Detail:
Title:  Chest     Volume:  137     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-07     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1304-9     Citation Subset:  AIM; IM    
Affiliation:
Cattedra di Malattie dell'Apparato Respiratorio, Spedali Civili, Brescia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Airway Obstruction / physiopathology
Analysis of Variance
Body Mass Index
Exhalation / physiology*
Humans
Linear Models
Male
Middle Aged
Neck / anatomy & histology
Pharynx / physiopathology*
Pressure
Respiratory Function Tests
Risk Factors
Sleep Apnea Syndromes / physiopathology*
Snoring / physiopathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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