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Polysomnography in Acutely III Intensive Care Unit Patients
Section snippets
METHODS
We analyzed the data from nine acutely ill patients who underwent PSG in our sleep laboratory between November 1, 1988, and November 1, 1990. All patients were referred to our laboratory during their admissions to the medical ICUs of two teaching hospitals. All patients were in acute RF at the time of referral (ie, room air arterial blood gas values: PaO2 <50 mm Hg and/or PaCO2 >50 mm Hg). All patients underwent daytime PSG while still resident in the ICUs. No patient was studied while
RESULTS
The data for the patients are presented in Table 1. This was a heterogeneous group of nine patients. In six patients RF was due to obesity-related problems; in two, to neuromuscular disease; and in one, to end-stage COPD. They were all in RF with pH of 7.30 ± 0.03, PCO2 of 80.8 ± 8.6 mm Hg, and PO2 of 48.1 ± 6.8 mm Hg (values are mean ± SEM). Seven of the nine had associated cor pulmonale, five had coronary disease or arterial hypertension, and four had diabetes mellitus. Seven of nine subjects
DISCUSSION
Polysomnography can be extremely useful in certain acutely ill patients. Patients with unexplained respiratory failure and a suspected sleep disorder require urgent diagnosis and treatment; this is possible if evaluation of sleep and breathing is performed while they are acutely ill. These patients are frequently unstable and are not easily brought into the sleep laboratory. Our medical center does not have a portable PSG system, and we described the procedures we used in studying these
CONCLUSION
We conclude from our study that, under well-controlled circumstances, it is feasible, efficacious, and safe to study acutely ill ICU patients for the purpose of diagnosing an underlying sleep disorder and treating the disorder appropriately. Early diagnosis and treatment of the underlying problem may lead to avoidance of endotracheal intubation and mechanical ventilation, and may lead to reductions in morbidity and length of stay in the ICU.
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