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Sunday 15.09.2002
Lung mechanics: from laboratory to bedside
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Effects of changing the properties of breathing gas on the collapsibility of the upper airway in patients with obstructive sleep apnoea
J. Rigau, J. M. Montserrat, M. Grabulosa, X. Trepat, D. Navajas, R. Farré (Barcelona, Spain)
Source:
Annual Congress 2002 - Lung mechanics: from laboratory to bedside
Session:
Lung mechanics: from laboratory to bedside
Session type:
Oral Presentation
Number:
187
Disease area:
Sleep and breathing disorders
Abstract
Hypopneas and flow limitation in patients with the obstructive sleep apnea-hypopnea syndrome (SAHS) result from increased upper airway collapsibility. The Starling resistor, characterized by a critical pressure (Pcrit) and an upstream resistance (Ru), is a simple model to describe the upper airway in SAHS. According to this model, changing the properties of the breathing gas would modify Ru but not Pcrit.
Aim
: To measure upper airway collapsibility in SAHS patients breathing different gases and to interpret the data with the Starling model.
Methods
: Five SAHS patients (BMI=32±]5 kg/m
2
, AHI=67±]14 h
-1
(mean±]SD)) were studied during a nap. The patients breathed air and He-O
2
(79%He-21%O
2
; density=0.33 and viscosity=1.17 relative to air) in random order. For each gas, incremental levels of nasal CPAP were applied during non-REM sleep. Maximal inspiratory flow (V'
I,MAX
) for each CPAP and breathing gas was measured. Ru and Pcrit were derived from the Starling model equation (V'
I,MAX
=(CPAP-Pcrit)/Ru).
Results
: Pcrit was 4.7±]2.7 cmH
2
O in He-O
2
and 3.0±]2.7 cmH
2
O in air (p<0.01). Ru during He-O
2
breathing (9.7±]1.6 cmH
2
O·s/L) was markedly lower (p<0.01) than Ru measured during air breathing (17.7±]1.9 cmH
2
O·s/L).
Conclusion
: These results are consistent with a quasi-turbulent gas flow regime during hypopneas and flow limitation events in SAHS patients.
Supported in part by: CICYT-SAF99-0001 and DGESIC-PM99-0027
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Citations should be made in the following way:
J. Rigau, J. M. Montserrat, M. Grabulosa, X. Trepat, D. Navajas, R. Farré (Barcelona, Spain). Effects of changing the properties of breathing gas on the collapsibility of the upper airway in patients with obstructive sleep apnoea. Eur Respir J 2002; 20: Suppl. 38, 187
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