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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 and Arzt, Michael (2023) Predictors of Nocturnal Hypoxemic Burden in Patients Undergoing Elective Coronary Artery Bypass Grafting Surgery. Biomedicines 11 (10), p. 2665.

Date of publication of this fulltext: 29 Sep 2023 14:24
Article
DOI to cite this document: 10.5283/epub.54772


Abstract

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

Item typeArticle
Journal or Publication TitleBiomedicines
Publisher:MDPI
Place of Publication:BASEL
Volume:11
Number of Issue or Book Chapter:10
Page Range:p. 2665
Date28 September 2023
InstitutionsMedicine > Lehrstuhl für Anästhesiologie
Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie
Medicine > Lehrstuhl für Innere Medizin II
Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien
Identification Number
ValueType
10.3390/biomedicines11102665DOI
KeywordsCENTRAL SLEEP-APNEA; HEART-FAILURE; FLUID SHIFT; OBESITY; COPD; DESATURATION; MORTALITY; T90; nocturnal hypoxemia; sleep apnea; heart failure
Dewey Decimal Classification600 Technology > 610 Medical sciences Medicine
StatusPublished
RefereedYes, this version has been refereed
Created at the University of RegensburgYes
URN of the UB Regensburgurn:nbn:de:bvb:355-epub-547727
Item ID54772

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