ABSTRACT
Background: Obstructive sleep apnea [OSA] is a condition of sleep related pharyngeal collapse, in which recurrent episodes of upper airway occlusion occur during sleep causing diminution [hypopnea] or cessation of airflow [apnea] in the pharynx provoking arousals and sleep fragmentation, resulting in daytime sleepiness. Oximetry alone is very valuable tool in the diagnosis and management of OSA, it can identify most cases allowing referral for continuous positive airway pressure [CPAP] treatment
Objective: To evaluate the overnight oximetry monitoring as a swift and accessible
Patients and Method: Cross sectional study of 20 patients, 12 males and 8 females with high probability of OSA, attended to respiratory clinic in Baghdad teaching hospital suffering from excessive daytime sleepiness, they were clinically evaluated plus using overnight oximetry as an objective testing method
Results: The study sample was 20 patients, 12 males [60%], 8 females [40%], mean age 48 years, mean BMI 45.6 Kg/m[2], female mean BMI 53.1 Kg/m[2], male mean BMI 37 Kg/m[2], and mean basal Po2 saturation 89.6 %. Desaturation index [DI] show significant correlation with AHI, BMI, and gender, while no significant correlation with age. AHI show significant correlation with baseline SPO 2 and gender, and no correlation with BMI and age
Conclusion: Desaturation index assessed by nocturnal pulse oximetry maintain its utility as a screening method in the recognition of obstructive sleep apnea in obese patients with high clinical pretest suspicion. DI when combined with appropriate clinical evaluation could be used as an initial diagnostic test for OSA
ABSTRACT
Spirometry is the recommended investigation for diagnosis and categorization of the severity of the air flow limitation, however Spirometer is not widely available, while Peak-flow meter is cheap, portable, and easy to operate and maintain, so the PEF is frequently proposed as alternative to FEV1 for this purpose, and widely used in general practice as a surrogate for FEV1 in assessment of airway obstruction diseases. To determine effect of FEV1 and PEF in obstructive airway diseases. This study was took place between 1[st] December 2006 and 1[st] July 2007 in Baghdad teaching hospital. A total of 100 patients with history suggestive of obstructive airway diseases [symptoms of cough, wheezes, shortness of breath, and chest tightness], and their pulmonary function test show obstructive pattern [FEV1/FVC <70%] were included. They were [60%] male and [40%] female, and their age ranged from 16 to 82 years. In screening for obstructive airway diseases, there was a significant relationship [P value 0.05] between FEV1% and PEF%, [94%] of patients with obstructive airway disease as assessed by FEV1% [FEV1%< 80%] had PEF%< 80%.In severity categorization, the PEF% and FEV1% were concordant in only [60%] of patients, with better concordance as severity of obstruction [based on FEV1%] became more. In patients with mild to moderate airway obstruction [FEV1%>40%], PEF% tended to underestimate FEV1%; while in patients with more severe obstruction [FEV1%< =40%], PEF% tended to overestimate FEV1%. For the entire study population, PEF% underestimated FEV1% by mean of only 0.35%. However, limits of agreement were wide and exceeded-/+ 14.5. In our study 70% of patients had discordance more than 5% apart between PEF% and FEV1%, [which could be considered clinically important error for estimation of severity of airway obstruction], and this discordance more marked in women, short patients, and in patients with mild airway obstruction. The PEF% can reliably exclude airway obstruction, when normal value is present. Assumption of parity between PEF% and FEV1% must be avoided especially in categorization of severity of air way obstruction