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Respiratory Care |

Utility of Respiratory Polygraphy in the Intensive Care Unit

Eduardo Borsini, MD; Emiliano Descotte, MD; Miguel Blasco, MD; Elias Soloaga, MD; Jose Luis Soto, RT; Felipe Chertcoff, MD
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British Hospital, Buenos Aires, Argentina


Chest. 2013;144(4_MeetingAbstracts):884A. doi:10.1378/chest.1702700
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Abstract

SESSION TITLE: Respiratory Support Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: To evaluate the usefulness of respiratory polygraphy (RP) in intensive care.

METHODS: Twenty-one records were retrospectively analyzed in 20 patients admitted to intensive care with a five channels polygraph sleep recorder during the period from 05/22/10 to 05/22/2012. We reviewed the reason for admission, indication for NIV, prior use of positive pressure equipment, and the impact on the treatment that had its fulfillment.

RESULTS: During this period 20 patients were studied, 15 men (75%), with an average age of 60 years and a mean BMI of 36. All admitted for respiratory failure with hypoxemia and PaCO2 average: 57.35 mmHg. Seven were not hypercapnic. Diagnoses were; Obstructive sleep apnea (n = 7, 35%), obesity-hypoventilation (n = 1, 5%), Overlap Syndrome (4, 20%) neuromuscular disease (n = 5, 25%), restrictive disease (n = 1, 5%) and acute exacerbation of COPD (n = 2, 10%). In all cases positive pressure therapy was indicated during hospitalization, six patients were using previously and fourteen cases it should be continued at discharge. Indications for the RP were suspected need for optimizing the use of the equipment in which was already indicated (5 patients) and whether or not to continue treatment at discharge in the remaining 15. The delay in the realization of the RP was 2.11 days and the average stay in ICU of 4.9 days. Nineteen patients were discharged with home NIV indication. In six with previous use we change the mode: CPAP to BIPAP (n = 1), adding AVAPS (n = 1) and change of masks by excessive loss (2 cases). In 10 patients (50%) analysis of RP determined modification pressure levels, adding oxygen (n = 3, 15%) and helped NIV suspension (no indication chronic) in one case.

CONCLUSIONS: The polygraph can be useful in patients admitted for respiratory failure in intensive care who use some form of NIV or the clinical situation (OSAHS, obesity, severe hypercapnic COPD or neuromuscular disease prior) predict a possible chronic indications.

CLINICAL IMPLICATIONS: The simplicity and speed of implementation and the wide range of recorded data allow taking behaviors that improve the application of the NIV.

DISCLOSURE: The following authors have nothing to disclose: Eduardo Borsini, Emiliano Descotte, Miguel Blasco, Elias Soloaga, Jose Luis Soto, Felipe Chertcoff

No Product/Research Disclosure Information


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