Prevalence of sleep-related hypoventilation according to different diagnostic criteria
Prevalencia de la hipoventilación relacionada con el sueño según diferentes criterios diagnósticos
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INTRODUCTION: Alveolar hypoventilation is an alteration that leads to retention of carbon dioxide (CO2) and alteration in blood pressure of CO2 (PaCO2) due to multiple causes (hypoventilation syndromes). The diagnosis is with resting daytime blood gasometry with possible use of other tests such as the measurement of transcutaneous carbon dioxide (TcCO2).
The diagnostic strategy is not yet fully defined, so our objective was to evaluate the prevalence of hypoventilation during sleep using different diagnostic criteria.
MATERIALS AND METHODS: Observational, descriptive, retrospective, cross-sectional study of patients who required po- lysomnography between 2015 and 2016 with measurement of TcCO2 at the National Institute of Respiratory Diseases Ismael Cosio Villegas of Mexico City. Six different criteria of hypoventilation were applied during sleep. Three groups were established (without
respiratory disorders during sleep, patients with hypoventilation-obesity syndrome and patients with hypoventilation related to medi- cal-neuromuscular disorder). Patients who had no established diagnosis were excluded. The SenTec Digital Monitoring System was used to measure the TcCO2, obtaining baseline CO2, average CO2, maximum CO2 and CO2 time. The software SPSS v23 was used.
The description was made with mean, median, standard deviation and percentages according to the type of variable. Concordance
tests were performed between the different criteria applied for each distribution. Statistical significance was accepted when p <0.05.
RESULTS: A total sample of 143 patients. 51 without respiratory disorders during sleep, 63 with hypoventilation-obesity syn- drome and 29 with hypoventilation related to medical disorders (neuromuscular). The male gender predominated and they were young adults. A TcCO2 >38 mm Hg is diagnosed in 68% of patients with hypoventilation-obesity syndrome and 69% of patients
with alveolar hypoventilation due to neuromuscular diseases (Cohen’s Kappa = 0.40). A TcCO2 >49 mm Hg at night diagnosed 82%
of patients with hypoventilation-obesity syndrome and 58% of patients with alveolar hypoventilation due to neuromuscular diseases
(Cohen’s Kappa = 0.63).
CONCLUSION: In the population studied, a peak of TcCO2 ≥49 mm Hg has a good degree according to the current diagnosis of the patient.
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