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Clinical Investigations: Sleep and BreathingDaytime Hypercapnia in Adult Patients With Obstructive Sleep Apnea Syndrome in France, Before Initiating Nocturnal Nasal Continuous Positive Airway Pressure Therapy
Section snippets
Materials and Methods
We used the database of the observatory of a national nonprofit network for home treatment of patients with chronic respiratory insufficiency (Association Nationale pour le Traitement A Domicile de l'Insuffisance Respiratoire chronique [ANTADIR]). ANTADIR was set up in France in the 1970s as a nonprofit network for the home treatment of patients with chronic respiratory insufficiency. Home treatment of patients with OSAS was started in 1985. ANTADIR has collected clinical data on treated
Results
During the study period, 88,548 patients with chronic respiratory insufficiency and 30,131 patients with OSAS needing CPAP therapy were included in the ANTADIR observatory. The values of FEV1, VC, and arterial blood gases were available in 2,217 adult patients with OSAS, defined by an AHI ≥ 10 events/h, and free of a restrictive respiratory disease other than that related to obesity. Age, sex ratio, BMI, and AHI did not significantly differ between the patients with OSAS in whom pulmonary
Discussion
This study shows that the prevalence of daytime hypercapnia for OSAS is 11% in the absence of associated COPD, in a very large group of adult patients with OSAS, before initiating CPAP therapy. The prevalence of daytime hypercapnia is particularly high (24%) for OSAS associated with massive obesity. Apart from the PaO2, the predictive variables of PaCO2 are the BMI, and the VC or the FEV1. However, these variables can only explain < 10% of the PaCO2 variance, and daytime hypercapnia has been
Conclusion
The prevalence of daytime hypercapnia was 11% in a very large group of patients with OSAS needing CPAP therapy and free of COPD. The prevalence of daytime hypercapnia was related to the severity of obesity and obesity-related impairment in lung function, and was especially high (> 20%) in patients with massive obesity. However, daytime hypercapnia was also demonstrated in patients without obesity, with a prevalence of 7%. Further studies should be performed to estimate the prevalence of daytime
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Obesity, malnutrition, and trace element deficiency in the coronavirus disease (COVID-19) pandemic: An overview
2021, NutritionCitation Excerpt :OHS presents with respiratory failure, severe hypoxemia, daytime hypercapnia (partial pressure of carbon dioxide [PaCO2] >6 kPa), and pulmonary hypertension [59]. It occurs in >11% of obese patients, with a proportional relationship between BMI and the hypercapnia severity [70]. Makinodan et al. demonstrated a significant association between PaCO2 values and higher serum leptin levels in obese patients with OSAH, so it has been suggested that a different sensitivity to circulating leptin could explain why many patients with OSAH do not necessarily progress to OHS [71–74].
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