scholarly journals Respiratory failure: technical means for diagnosis and respiratory support

Doklady BGUIR ◽  
2020 ◽  
Vol 18 (8) ◽  
pp. 29-36
Author(s):  
Е. I. Davidovskaya ◽  
A. S. Dubrovski ◽  
О. В. Zelmanski
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Respiratory Failure ◽  
Pulse Oximetry ◽  
Respiratory Diseases ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Hypopnea Syndrome ◽  
Cpap Devices

The necessity of early diagnosis of respiratory diseases, especially in the context of the COVID-19 pandemic, by means of pulse oximetric screening and monitoring has been substantiated. The expediency of using portable pulse oximeters by therapists and general practitioners has been shown. The main respiratory diseases accompanied by respiratory failure, which can be detected in time by pulse oximetry, are the chronic obstructive pulmonary disease and the obstructive sleep apnea-hypopnea syndrome. Early detection of these diseases is an important task because of the mild symptoms of these diseases in the early stages, and as a result, the prevalence of late diagnosis. Special attention is given to the pulse oximetry for COVID-19 detection, as this infection is also accompanied by respiratory failure. The use of oxygen concentrators and auto CPAP devices for the treatment of respiratory failure as well as rehabilitation has been argued. The effectiveness of the appointment of long-term oxygen therapy using oxygen concentrators for patients with chronic obstructive pulmonary disease, CPAP therapy using automatic CPAP devices for patients with obstructive sleep apnea-hypopnea syndrome with mandatory pulse oximetry monitoring has been confirmed. The analysis of 120 cases of treatment of moderate and severe COVID-19 cases complicated by the pneumonia has been carried out. The efficiency of the use of oxygen concentrators for supplying oxygen to patients at a flow rate not more than 5 l/min has been proven. It has been found that no more than 10 % of patients needed an oxygen flow rate more than 5 l/min. At the same time, the possibility of using CPAP devices for non-invasive ventilation of lungs using full-face masks has been shown. The expediency of using oxygen concentrators and CPAP devices for the rehabilitation of patients after COVID-19 has been noted.

scholarly journals Examination of Pulse Oximetry Tracings to Detect Obstructive Sleep Apnea in Patients with Advanced Chronic Obstructive Pulmonary Disease

2014 ◽  
Vol 21 (3) ◽  
pp. 171-175 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pulse Oximetry ◽  
Pulmonary Disease ◽  
Time Scale ◽  
Apnea Hypopnea Index ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Nocturnal hypoxemia and obstructive sleep apnea (OSA) are common comorbidities in patients with chronic obstructive pulmonary disease (COPD). The authors sought to develop a strategy to interpret nocturnal pulse oximetry and assess its capacity for detection of OSA in patients with stage 3 to stage 4 COPD. A review of consecutive patients with COPD who were clinically prescribed oximetry and polysomnography was conducted. OSA was diagnosed if the polysomnographic apnea-hypopnea index was >15 events/h. Comprehensive criteria were developed for interpretation of pulse oximetry tracings through iterative validation and interscorer concordance of ≥80%. Criteria consisted of visually identified desaturation ‘events’ (sustained desaturation ≥4%, 1 h time scale), ‘patterns’ (≥3 similar desaturation/saturation cycles, 15 min time scale) and the automated oxygen desaturation index. The area under the curve (AUC), sensitivity, specificity and accuracy were calculated. Of 59 patients (27 male), 31 had OSA (53%). The mean forced expiratory volume in 1 s was 46% of predicted (range 21% to 74% of predicted) and 52% of patients were on long-term oxygen therapy. Among 59 patients, 35 were correctly identified as having OSA or not having OSA, corresponding to an accuracy of 59%, with a sensitivity and specificity of 59% and 60%, respectively. The AUC was 0.57 (95% CI 0.55 to 0.59). Using software-computed desaturation events (hypoxemia ≥4% for ≥10 s) indexed at ≥15 events/h of sleep as diagnostic criteria, sensitivity was 60%, specificity was 63% and the AUC was 0.64 (95%CI 0.62 to 0.66). No single criterion demonstrated important diagnostic utility. Pulse oximetry tracing interpretation had a modest diagnostic value in identifying OSA in patients with moderate to severe COPD.

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