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Poster Walks: Poster Walk 3: Sleep/Breathing |

P170 Positional central sleep apnea after single-lung transplantation - a case report

A. Schertel; C.M. Horvath; J. Pichler Hefti; J.-D. Aubert; A.-K. Brill
Author and Funding Information

1Department of Pulmonary Medicine, University Hospital and University of Bern, Bern

2Division of Pulmonary Diseases, Lausanne University Hospital, Lausanne, Switzerland


Copyright 2017, American College of Chest Physicians and Swiss Respiratory Society SGP. All Rights Reserved.


Chest. 2017;151(5_S):A68. doi:10.1016/j.chest.2017.04.072
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Background: Central sleep apnea (CSA) is a common comorbidity in heart failure and also seen in lung transplant recipients. If positional sleep apnea is present, the lateral position often leads to an improvement of the apnea-hypopnea-index (AHI) and oxygenation. Single-lung transplantation (sLTX) results in changes in pulmonary hemodynamics and ventilation. We present a case of posture dependent aggravation of CSA in single-lung transplant recipient.

Case report: A 58-year-old patient with a favorable course after a right-sided sLTX for idiopathic pulmonary fibrosis (IPF) reported of nocturnal dyspnea in the right lateral position. He was also known for stable cardiovascular disease. Lung scintigraphy showed a perfusion (P) and ventilation (V) in favor of the graft (V 88%/ P 95%), the LV-EF was 50%. There was a small pleural effusion on the left side. After exclusion of other pathologies and confirmation of a good graft function a polysomnography revealed severe central sleep apnea with an AHI of 61.0/h. Parameters of sleep apnea and desaturations were clearly worse in the right lateral position: right vs left: AHI 78/h vs. 33/h, mean SpO2 70% vs. 84% and mean desaturation per event of 17.3% vs. 5.2%.

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