在药物诱导的睡眠内镜检查过程中,喉计量和上呼吸道崩
Tice Harkins1, Akshay Tangutur1, Brendan T Keenan2
1Department of Otorhinolaryngology-Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia.
JAMA otolaryngology-- head & neck surgery
|August 29, 2024
概括
药物诱导睡眠内镜显示,阻塞性睡眠呼吸暂停治疗应针对喉崩的主要部位. 只有在具有相似的折叠性时,二次部位才需要干预,以指导个性化的OSA治疗.
科学领域:
- 睡眠医学 睡眠医学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 药物诱导睡眠内镜 (DISE) 对于指导阻塞性睡眠呼吸暂停 (OSA) 治疗至关重要,通过识别喉崩模式.
- 然而,对于个体喉部位的精确折叠性仍然不太了解,这限制了针对性的治疗策略.
研究的目的:
- 在接受DISE的OSA患者中评估喉缩部位.
- 为了确定崩点的数量和位置是否与气道的崩性相关.
- 在多层崩中量化初级和二级地点之间的崩性差异.
主要方法:
- 一项包括成年OSA患者在内的队列研究,这些患者接受了DISE,并进行了气压测量和正气道压力 (PAP) 定位.
- 使用活跃的喉临界压力 (Pcrit-A) 和喉开口压力 (PhOP) 来量化气道折叠性的量化.
- 根据年龄,性别,种族和BMI进行调整的统计分析.
主要成果:
- 在66名被录取的患者中,71.2%患有多层次崩.
- 与单一层次的鼻内崩相比,单一层次的鼻内崩显示出明显更高的崩性.
- 在多层崩中,主要的鼻部位比二次的下巴部位更容易崩.
结论:
- 对OSA的干预应优先考虑在DISE期间发现的喉崩的主要部位.
- 只有当二次崩现场的崩性与初级崩现场相似时,二次崩现场才有必要进行处理.
- 需要进一步的研究来确定可折叠性值,需要多层次的处理策略.
相关概念视频
Endoscopic Procedures I: Esophagogastroduodenoscopy
79
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
79
Stages of General Anesthesia
391
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
391
Endotracheal Tube Extubation
495
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
495
Gastroesophageal Reflux Disease II: Clinical Features and Management
62
Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
62
Upper GI Series: Barium Swallow
183
The Barium Swallow Study, or a Barium Esophagogram, is a diagnostic imaging method used to visualize the upper gastrointestinal (GI) tract, including the esophagus, stomach, and small intestine. It employs barium sulfate, a radiopaque contrast material, to provide clear images of the upper digestive system, helping to identify abnormalities, diseases, or structural issues.
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
Purpose and Procedure
Patients undergoing this procedure ingest a liquid containing barium sulfate with a chalky...
183
Sleepwalking and Sleep Talking
131
Somnambulism, commonly known as sleepwalking, involves individuals engaging in activities ranging from simple walking to more complex behaviors such as driving. Sleepwalking typically occurs during the slow-wave sleep stages 3 and 4 early in the night when the person is not dreaming, contradicting the myth that sleepwalkers are acting out their dreams.
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
Factors that increase the likelihood of sleepwalking include sleep deprivation and alcohol consumption. Contrary to common beliefs, it is safe...
131


