Source: International Congress 2015 – Best abstracts in chronic care
Disease area: Sleep and breathing disorders

Abstract

Background: NIV is effective to treat chronic or acute respiratory failure (RF). However, abnormal events (AE) may affect NIVefficacy. Among them, upper airway obstruction with (UAO/IE+) or without (UAO/IE-) inspiratory effort are expressed as desaturation dips (DD) on SpO2 tracings.Aim : 1) To assess the prevalence and epidemiology of DD in patients on NIV, 2) to characterize underlying AE, 3) to identify their predictive factors and associated conditions.Methods: Observational study analyzing all ventilatory polygraphies performed in patients (Pts) on NIV in our department between 1/2010 and 12/2012. Demographic, clinical and epidemiological data were collected. For desaturors patients (>15 DD/h), we scored and analyzed AE associated with DD.Results: Amongst the 219 Pts studied, 137 (63%) were classified as desaturors with 38±18 % of time spent on DD .Desaturation index was 40±23/h. Higher BMI, lower vital capacity, history of sleep apnea and cardiac or neurologic disease, thoracic cage disorders and use of facial mask were all significantly associated with higher desaturation index but only BMI and vital capacity when multivariate analysis was performed.In 52 Pts (47%) DD were predominantly due to UAO/IE+ and in 27 (24%) to UAO/IE-. The predominant type of AE did not differ according to acute or chronic situation nor with the etiology of RF, type of mask or ventilator settings.Conclusion: DD on NIV are frequent. Higher BMI, more severe RF, thoracic cage abnormalities and comorbidities seem to be associated factors. Further studies are needed to confirm the place of ovenight oxymetry as a tool for monitoring NIV.


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Claudio Rabec (Dijon, France), Claire-Marie Monnet, Claudio Rabec, Marjolaine Georges, Clement Foignot, Philippe Camus, Philippe Bonniaud. Epidemiology of desaturation dips in a cohort of patients under non-invasive ventilation (NIV). Eur Respir J 2015; 46: Suppl. 59, 3064

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