Validation of a measurement to predict upper airway collapsibility during sedation for colonoscopy

被引:5
|
作者
Karan, Suzanne B. [1 ]
Rackovsky, Elia D. [1 ]
Voter, William A. [1 ]
Shah, Ashok N. [2 ]
Ward, Denham S. [3 ]
机构
[1] Univ Rochester, Sch Med & Dent, Dept Anesthesiol, Rochester, NY 14642 USA
[2] Univ Rochester, Sch Med & Dent, Dept Med, Rochester, NY 14642 USA
[3] Univ Rochester, Sch Med & Dent, Dept Anesthesiol & Biomed Engn, Rochester, NY 14642 USA
关键词
Airway collapsibility; Negative airway pressure; Sedation; Critical pharyngeal pressure (Pcrit); OBSTRUCTIVE SLEEP-APNEA; PASSIVE PHARYNX; PRESSURE DNAP; PROPOFOL; ANESTHESIA; MIDAZOLAM; POSITION; HEAD;
D O I
10.1007/s10877-012-9374-9
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Techniques to quantify the effects of sedation on upper airway collapsibility have been used as research tools in the laboratory and operating room. However, they have not been used previously in the usual clinical practice environment of colonoscopy sedation. The propensity for upper airway collapsibility, quantified as the critical pharyngeal pressure (P-crit), was hypothesized to correlate with the need for clinical intervention to maintain ventilation. Twenty patients scheduled for colonoscopy with sedation were prospectively recruited to undergo measurement of upper airway collapsibility using negative airway pressure (NAP) provocation with a minimum pressure of -18 cmH(2)O. The P-crit was the negative pressure that collapses the airway, either directly or by extrapolation from the pressure-flow relationship. An exponential transformation was applied to the P-crit data for statistical analysis. A clinical intervention score (CIS) was used to quantify required interventions by the sedation nurse. The measurement of the P-crit during sedation was significantly larger (less negative) than both the baseline ("awake") (P = 0.0029) and late recovery (P = 0.01) values. The CIS was not predicted by the transformed baseline or sedated P-crit with or without including demographics associated with sleep apnea syndrome. Although the NAP technique showed the expected changes with sedation in this clinical situation, we did not find that it predicted the need for clinical intervention during endoscopy. Our study was not large enough to test for subpopulations in which the test might be predictive; further studies of these particular groups are needed to determine the clinical utility of the NAP measurement.
引用
收藏
页码:451 / 457
页数:7
相关论文
共 50 条
  • [1] Validation of a measurement to predict upper airway collapsibility during sedation for colonoscopy
    Suzanne B. Karan
    Elia D. Rackovsky
    William A. Voter
    Ashok N. Shah
    Denham S. Ward
    [J]. Journal of Clinical Monitoring and Computing, 2012, 26 : 451 - 457
  • [2] Upper airway collapsibility during dexmedetomidine and propofol sedation
    Lodenius, A.
    Maddison, K.
    Lawther, B.
    Scheinin, M.
    Eriksson, L.
    Eastwood, P.
    Hillman, D.
    Fagerlund, M. J.
    Walsh, A. J.
    [J]. JOURNAL OF SLEEP RESEARCH, 2018, 27
  • [3] The effects of mandible advancement on upper airway collapsibility during midazolam sedation.
    Ayuse, T.
    Ol, K.
    [J]. JOURNAL OF DENTAL RESEARCH, 2003, 82 : B276 - B276
  • [4] Upper airway collapsibility during sleep in upper airway resistance syndrome
    Gold, AR
    Marcus, CL
    Dipalo, F
    Gold, MS
    [J]. CHEST, 2002, 121 (05) : 1531 - 1540
  • [5] Upper Airway Collapsibility during Dexmedetomidine and Propofol Sedation in Healthy Volunteers A Nonblinded Randomized Crossover Study
    Lodenius, Ase
    Maddison, Kathleen J.
    Lawther, Brad K.
    Scheinin, Mika
    Eriksson, Lars, I
    Eastwood, Peter R.
    Hillman, David R.
    Fagerlund, Malin Jonsson
    Walsh, Jennifer H.
    [J]. ANESTHESIOLOGY, 2019, 131 (05) : 962 - 973
  • [6] Dexmedetomidine Sedation and Airway Collapsibility: Reply
    Lodenius, Ase
    Fagerlund, Malin Jonsson
    [J]. ANESTHESIOLOGY, 2020, 132 (06) : 1609 - +
  • [7] Dexmedetomidine Sedation and Airway Collapsibility: Comment
    Zhu, Binbin
    Zhang, Lina
    [J]. ANESTHESIOLOGY, 2020, 132 (06) : 1609 - 1609
  • [8] Collapsibility of the upper airway during anestbesia witb isoflurane
    Eastwood, PR
    Szollosi, I
    Platt, PR
    Hillman, DR
    [J]. ANESTHESIOLOGY, 2002, 97 (04) : 786 - 793
  • [9] AWAKE UPPER AIRWAY COLLAPSIBILITY IS RELATED TO AIRWAY COLLAPSIBILITY DURING SLEEP (PCRIT) IN OBSTRUCTIVE SLEEP APNOEA
    Osman, A.
    Nguyen, C.
    Carberry, J.
    Burke, P.
    Wijesuriya, N.
    Tong, B.
    Grunstein, R.
    Eckert, D.
    [J]. JOURNAL OF SLEEP RESEARCH, 2016, 25 : 20 - 20
  • [10] COLLAPSIBILITY OF THE HUMAN UPPER AIRWAY DURING NORMAL SLEEP
    WIEGAND, L
    ZWILLICH, CW
    WHITE, DP
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 1989, 66 (04) : 1800 - 1808