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Tafelmeier, Maria ; Blagoeva, Verka-Georgieva ; Trum, Maximilian ; Hegner, Philipp ; Floerchinger, Bernhard ; Camboni, Daniele ; Creutzenberg, Marcus ; Zeman, Florian ; Schmid, Christof ; Maier, Lars Siegfried ; Wagner, Stefan ; Linz, Dominik ; Baumert, Mathias ; Arzt, Michael

Predictors of Nocturnal Hypoxemic Burden in Patients Undergoing Elective Coronary Artery Bypass Grafting Surgery

Tafelmeier, Maria , Blagoeva, Verka-Georgieva, Trum, Maximilian , Hegner, Philipp , Floerchinger, Bernhard, Camboni, Daniele, Creutzenberg, Marcus, Zeman, Florian, Schmid, Christof, Maier, Lars Siegfried , Wagner, Stefan , Linz, Dominik , Baumert, Mathias und Arzt, Michael (2023) Predictors of Nocturnal Hypoxemic Burden in Patients Undergoing Elective Coronary Artery Bypass Grafting Surgery. Biomedicines 11 (10), S. 2665.

Veröffentlichungsdatum dieses Volltextes: 29 Sep 2023 14:24
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.54772


Zusammenfassung

Background: Nocturnal hypoxemia has been linked to increased cardiovascular morbidity and mortality. Several common diseases, such as sleep-disordered breathing (SDB), heart failure (HF), obesity, and pulmonary disease, coincide with an elevated nocturnal hypoxemic burden with and without repetitive desaturations. Research question: This study aimed to evaluate the association of relevant common ...

Background: Nocturnal hypoxemia has been linked to increased cardiovascular morbidity and mortality. Several common diseases, such as sleep-disordered breathing (SDB), heart failure (HF), obesity, and pulmonary disease, coincide with an elevated nocturnal hypoxemic burden with and without repetitive desaturations. Research question: This study aimed to evaluate the association of relevant common diseases with distinctive metrics of nocturnal hypoxemic burden with and without repetitive desaturations in patients undergoing coronary artery bypass grafting surgery. Study design and methods: In this subanalysis of the prospective observational study, CONSIDER-AF (NCT02877745) portable SDB monitoring was performed on 429 patients with severe coronary artery disease the night before cardiac surgery. Pulse oximetry was used to determine nocturnal hypoxemic burden, as defined by total recording time spent with oxygen saturation levels < 90% (T90). T90 was further characterized as T90 due to intermittent hypoxemia (T90(desaturation)) and T90 due to nonspecific and noncyclic SpO(2)-drifts (T90(non-specific)). Results: Multivariable linear regression analysis identified SDB (apnea-hypopnea-index >= 15/h; B [95% CI]: 6.5 [0.4; 12.5], p = 0.036), obesity (8.2 [2.5; 13.9], p = 0.005), and mild-to-moderate chronic obstructive pulmonary disease (COPD, 16.7 [8.5; 25.0], p < 0.001) as significant predictors of an increased nocturnal hypoxemic burden. Diseases such as SDB, obesity and HF were significantly associated with elevated T90(desaturation). In contrast, obesity and mild-to-moderate COPD were significant modulators of T90(non-specific). Interpretation: SDB and leading causes for SDB, such as obesity and HF, are associated with an increased nocturnal hypoxemic burden with repetitive desaturations. Potential causes for hypoventilation syndromes, such as obesity and mild-to-moderate COPD, are linked to an increased hypoxemic burden without repetitive desaturations.



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Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftBiomedicines
Verlag:MDPI
Ort der Veröffentlichung:BASEL
Band:11
Nummer des Zeitschriftenheftes oder des Kapitels:10
Seitenbereich:S. 2665
Datum28 September 2023
InstitutionenMedizin > Lehrstuhl für Anästhesiologie
Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie
Medizin > Lehrstuhl für Innere Medizin II
Medizin > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien
Identifikationsnummer
WertTyp
10.3390/biomedicines11102665DOI
Stichwörter / KeywordsCENTRAL SLEEP-APNEA; HEART-FAILURE; FLUID SHIFT; OBESITY; COPD; DESATURATION; MORTALITY; T90; nocturnal hypoxemia; sleep apnea; heart failure
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenJa
URN der UB Regensburgurn:nbn:de:bvb:355-epub-547727
Dokumenten-ID54772

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