An analysis of the cause and countermeasure of death of patients with severe obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To discuss the causes and countermeasures of death of severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients undergoing tests or treatment.</p><p><b>METHODS</b>A retrospective study of the data of six patients with severe OSAHS who died undergoing tests or treatment in 6 hospitals was conducted.</p><p><b>RESULTS</b>Among the 6 patients, overly fat were found in 2 cases, hypertension in 2 cases, cardiac diseases in 2 cases, abnormal pulmonary function or chest X-ray in 2 cases, diabetes in 2 cases, while 2 cases had no above positive finding. Three patients did not have polysomnography (PSG). One patient died during PSG test. Two patients' apnea hypopnea index (AHI) were 56 times/h and 82 times/h respectively. The causes of death were as follows, two patients died of airway obstruction and unsuccessful tracheal intubation before uvulopalatopharyngoplasty (UPPP) operation. One died of encephaledema in long-term coma due to airway obstruction, long time poor oxygenation and unsuccessful tracheal intubation with muscle relaxants before hemostasis procedure for treating postoperative hemorrhage. One patient whose preoperative pulmonary function showed increased airway resistance died of cardiac and respiratory arrest after tracheal extubation when UPPP surgery finished. One who was found to have potential cardiac and pulmonary disorder died of cardiac arrest when doctors were replacing his tracheal intubation with a cannula, before the tube replacing procedure the patient was conscious. One who had hypertension, coronary heart disease, diabetes mellitus and adiposis suffering from respiratory acidosis with his electrocardiogram showing a level-three heart function died of cardiac arrest with repeated apnea during PSG monitoring.</p><p><b>CONCLUSIONS</b>OSAHS patients with severe complications should be treated extremely carefully. The indication of surgery should be strictly observed. OSAHS patients can not undergo surgery until their cardiopulmonary functions and general conditions are improved.</p>