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The Desaturation Index Evaluated by Nocturnal Pulse Oximetry in Recognition of Sleep Apnea Syndrome. A Comparison Between Patients With BMI>40 kg/m2 and BMI<30 kg/m2.

Chest 2012 October 2
SESSION TYPE: Sleep PostersPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: The nocturnal pulse oximetry is used as a validated screening method in the diagnostic approach of Sleep Apnea Syndrome (SAS). The aim is to asses the role of nocturnal pulse oximetry as a screening method in subjects with morbid obesity (BMI>40 kg/m2) comparing with those with BMI<30kg/m2.METHODS: We evaluated 123 obese (BMI>40 kg/m2) patients (Group A) and 76 patients with BMI<30kg/m2 (Group B) with high pre-test clinical suspicion of SAS (Epworth sleepiness scale >10, snoring, witnessed apneas). We performed respiratory polygraphy (pulse oximetry, nasal airflow, thoraco-abdominal movements, body position and snoring). We assessed the correlation between the values of Desaturation Index (DI) and Apneea Hypopnea Index (AHI) in both groups. The cut-off for independent desaturation was 3%.RESULTS: In group A, 116 patients (94.3%) were diagnosed with SAS (AHI>5/hour); mean age: 59,4 ± 10,9 years ( range 28 to 79); mean BMI: 44,8 ± 4,9 kg/m2 ( range 40 to 67,5). The mean DI was 47,2 ± 27,6/hour (range 2 to 131) and the mean AHI: 46,5 ± 27,6/hour (range 7 to 131). Mean average SaO2 was 88,5 ± 6,3 %. In group B, 65 patients (85,52 %) were diagnosed with SAS (AHI>5/hour); mean age: 51,2 ± 12,7 years ( range 28 to 77); mean BMI: 27,24 ± 2,2 kg/m2 ( range 21 to 30). The mean DI was 23,12 ± 18,35/hour (range 3 to 73) and the mean AHI: 28,8 ± 18,5/hour (range 5,2 to 79). Mean average SaO2 was 93,72 ± 2,074 %. We found a significant correlation (correlation index rA= 0,887 and rB= 0,859) between DI and AHI in both groups (p<0.001).CONCLUSIONS: Desaturation Index assessed by nocturnal oximetry maintains its utility in the recognition of SAS in both obese and non-obese patients, despite the fact that the basal nocturnal saturation is lower in group A due to hypoventilation in supine position during sleep.CLINICAL IMPLICATIONS: Desaturation Index is usefull in recognition of SAS in obese and non-obese patients with high clinical pre-test suspicion.DISCLOSURE: The following authors have nothing to disclose: Stefan Dumitrache-Rujinski, George Calcaianu, Dragos Zaharia, Alina Croitoru, Miron Alexandru BogdanNo Product/Research Disclosure Information"Marius Nasta" Pneumology Institute Bucharest, Bucharest, Romania.

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