4.Effect of information-motivation-behavior skills on adherence of continuous positive airway pressure therapy in patients with obstructive sleep apnea hypopnea syndrome.
Jingjie KUANG ; Yayong LI ; Silei DENG ; Jing SU ; Subo GONG ; Yina WANG
Journal of Central South University(Medical Sciences) 2022;47(4):479-487
OBJECTIVES:
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common disease that seriously affects health. Continuous positive airway pressure (CPAP) therapy is the preferred treatment for moderate-to-severe OSAHS patients. However, poor adherence to CPAP is a major obstacle in the treatment of OSAHS. Information-motivation-behavioral (IMB) skills, as a kind of mature technology to change the behavior, has been used in various health areas to improve treatment adherence. This study aims to explore the effects of the IMB skills intervention on CPAP adherence in OSAHS patients.
METHODS:
Patients who were primary diagnosed with moderate-to-severe OSAHS were randomly divided into the IMB group (n=62) and the control group (n=58). The patients in the IMB group received CPAP therapy and the IMB skills intervention for 4 weeks. The patients in the control group received CPAP therapy and a usual health care provided by a registered nurse. We collected the baseline data of the general information, including age, sex, body mass index (BMI), the Epworth Sleepiness Scale (ESS) score, the Hospital Anxiety and Depression Scale (HADS) score, and indicators about disease severity [apnea-hypopnea index (AHI), percentage of time with arterial oxygen saturation SaO2<90% (T90), average SaO2, lowest SaO2, arousal index]. After CPAP titration, we collected CPAP therapy-relevant parameters (optimal pressure, maximum leakage, average leakage, 95% leakage, and residual AHI), score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. After 4 weeks treatment, we collected the ESS score, HADS score, CPAP therapy-relevant parameters, effective CPAP therapy time per night, CPAP therapy days within 4 weeks, CPAP adherence rate, score of satisfaction and acceptance of CPAP therapy, and score of willingness to continue CPAP therapy. Visual analog scale (VAS) of 0-5 was used to evaluate the satisfaction and acceptance of IMB intervention measures in the IMB group.
RESULTS:
There were no significant differences in the baseline level of demographic parameters, ESS score, HADS score, disease severity, and CPAP therapy related parameters between the IMB group and the control group (all P>0.05). There were no significant differences in score of willingness to continue CPAP therapy, as well as score of satisfaction and acceptance of CPAP therapy after CPAP titration between the IMB group and the control group (both P>0.05). After 4 weeks treatment, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group were significantly decreased, while the score of satisfaction and acceptance of CPAP therapy and willingness to continue CPAP therapy of the IMB group were significantly increased (all P<0.05); while the above indexes in the control group were not different before and after 4 weeks treatment (all P<0.05). Compared with the control group, the ESS score, HADS score, maximum leakage, average leakage, and 95% leakage of the IMB group after 4 weeks treatment were significantly lower (all P<0.05); the effective CPAP therapy time, CPAP therapy days within 4 weeks, score of satisfaction and acceptance of CPAP therapy, score of willingness to continue CPAP therapy of the IMB group were significantly higher (all P<0.05). The rate of CPAP therapy adherence in 4 weeks of the IMB group was significantly higher than that of the control group (90.3% vs 62.1%, P<0.05). The VAS of overall satisfaction with IMB skills intervention measures was 4.46±0.35.
CONCLUSIONS
IMB skills intervention measures can effectively improve the adherence of CPAP therapy in OSAHS patients, and is suitable for clinical promotion.
Continuous Positive Airway Pressure
;
Humans
;
Motivation
;
Oximetry
;
Patient Compliance
;
Sleep Apnea, Obstructive/diagnosis*
;
Syndrome
5.Oxygen reserve index: a new parameter for oxygen therapy.
Chinese Journal of Contemporary Pediatrics 2022;24(11):1275-1280
Oxygen reserve index (ORI) is a novel dimensionless index used for noninvasive, real-time, and continuous monitoring of oxygenation, and ORI value ranges from 0 to 1, which reflects the range of 100-200 mmHg for arterial partial pressure of oxygen. ORI combined with pulse oximetry may help to accurately adjust the concentration of inspired oxygen and prevent hyperoxemia and hypoxemia. ORI is suitable for various clinical situations, and the medical staff should master this novel parameter and use it properly to assess the oxygenation of patients. In addition, several limitations of ORI should be noticed during clinical application.
Humans
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Oxygen
;
Blood Gas Analysis
;
Oxygen Inhalation Therapy
;
Oximetry
;
Hypoxia/therapy*
6.Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask.
Na ZHAO ; Yumiao JING ; Jufen GUAN ; Xiang LI ; Xiaoguang LI ; Yunfei XING ; Xinghua XIANG ; YongLi HOU ; Xuejiao HUANG ; Xiyue ZHANG ; Jinxin HE ; Xuejuan WANG ; Mingjun XU
Journal of Biomedical Engineering 2020;37(6):1025-1030
During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO
COVID-19
;
Healthy Volunteers
;
Humans
;
Masks
;
Oximetry
;
Oxygen/blood*
7.The accuracy of the Innovo Deluxe Fingertip Pulse Oximeter perfusion index in predicting hypotension during balanced general anesthesia induction – A prospective observational study
Brian Rainier T. Herradura ; Beverly Anne P. Portugal ; Olivia C. Flores
Health Sciences Journal 2020;9(1):6-11
INTRODUCTION:
Balanced general anesthesia technique is a popular choice for induction because it can minimize potential side effects from individual drugs when otherwise used alone. However, hypotension is still a common occurrence during induction. Perfusion Index (PI) has been used as a measure of systemic vascular resistance and has shown to predict hypotension after regional anesthesia and propofol induction. This study aimed to determine whether baseline PI can predict hypotension following balanced general anesthesia induction and determine a cut-off value where hypotension is expected to occur.
METHODS:
Thirty-five ASA I/II adults for elective surgery under general anesthesia were enrolled. Heart rate, blood pressure and PI were measured every minute from baseline to 5 minutes following induction and 10 minutes after endotracheal intubation. Hypotension was defined as fall in systolic BP (SBP) by >30% of baseline and/or mean arterial pressure (MAP) to <60 mmHg. Severe hypotension (MAP of <55 mm Hg) was treated.
RESULTS:
No hypotension was observed in the first 5 minutes. Within 10 minutes, hypotension occurred in 8.6% by SBP criterion and 2.6% by MAP criterion. Within 15 minutes, hypotension was seen in 5.7% by SBP and MAP criterion, respectively. PI showed very low (r < 0.2) to low (r = 0.2 to 0.39), negative to positive and insignificant correlation (p > 0.05) with hypotension whether using SBP or MAP criterion and whether observed at 10 or 15 minutes of anesthesia induction. The Area under the ROC curve is 0.397, 95% CI [0 .126, 0.667], p = 0.431.
CONCLUSION
This study lends inconclusive evidence on the usefulness of Innovo Deluxe Fingertip Pulse Oximeter with Plethysmograph and Perfusion Index to predict intraoperative hypotension following balanced general anesthesia induction for this sample of patients. However, there was a positive, moderate (r=0.538, 0.501 and 0.469) and significant (p<0.05) correlation between perfusion index and SBP, Diastolic BP and MAP, respectively.
oximetry
;
hypotension
;
Anesthesia, General
;
arterial pressure
;
blood pressure
;
Perfusion index
8.Predictive values of the combination of Friedman stage and sleep oximetry done early after surgery in predicting the treatment outcomes of uvulopalatopharyngoplasty.
Bing Wan DONG ; Jun Bo ZHANG ; Shui Fang XIAO
Journal of Peking University(Health Sciences) 2020;52(2):281-284
OBJECTIVE:
To explore the predictive values of the combination of preoperative data, including medical history and physical examination, and results of sleep oximetry performed early after the surgery (one week) in predicting the treatment outcomes of uvulopalatopharyngoplasty (UPPP) in adult patients with obstructive sleep apnea hypopnea syndrome (OSAHS).
METHODS:
All the patients who were diagnosed with OSAHS, underwent UPPP treatment and had complete follow-up data in our institution between Jan 2013 and May 2016 were enrolled in our study. The pre-operative data of these patients, including age, physical examination, and polysomnography (PSG) data, were all exactly collected for analysis. All these patients had received the evaluation of subjective efficacy scale and the sleep oximetry test in early post-operative days (within one week). The long-term efficacy evaluations including PSG and subjective efficacy scale were all finished at least three months after the surgery.
RESULTS:
In the research 61 patients were finally studied, including 25 responders (41.0%) and 36 non-responders (59.0%). Regression analysis revealed that the pre-operative Friedman stage and early post-operative oxygen desaturation index of ≥4% (ODI4) were found to be independently predictive parameters for the UPPP treatment outcomes (P<0.05). The ROC curve analysis was used to estimate the predictive values of ODI4 to the treatment outcomes, and it was calculated with an area under the curve of 0.822. Using the ODI4 of 15 as the cutoff value, the sensitivity and specificity of that calculated were up to 0.778 and 0.760 respectively. The response rate among the patients with an early post-operative ODI4 of <15 was 70.4%, which was significantly higher than that of the patients with an early post-operative ODI4 of ≥15, whose response rate was 17.6% (P<0.05). The similar results could also be obtained in the patients with pre-operative Friedman stage II (87.5% vs.25.0%) and Friedman stage III (33.3% vs. 6.7%).
CONCLUSION
The combination of early post UPPP operation oximetry parameters, especially ODI4, and pre-operative Friedman stage could be used in better evaluating the potential surgical outcomes of UPPP.
Adult
;
Humans
;
Oximetry
;
Palate
;
Pharynx
;
Polysomnography
;
Treatment Outcome
9.Development of a Portable Pulse Oxymetry Simulator System.
Maojie YUAN ; Jilun YE ; Xu ZHANG ; Jie LIU ; Bin WEN ; Kejian DOU
Chinese Journal of Medical Instrumentation 2019;43(5):345-347
This article describes the design of a portable blood oxygen simulation system that can be used to simulate various blood gas saturation states of the human body. The system can be used to simulate various states of blood gas saturation, and can also simulate large blood oxygen saturation dynamic range, pulse rate range and perfusion index range. It can be used for testing, but not for clinical examination instruments. Moreover, the system has the characteristics of small size and low cost compared with the commercial blood oxygen simulator. Although the simulation system is not directly used for the detection of blood gas saturation of patients, it is also an essential equipment in the production and testing process, so it has certain practical value.
Heart Rate
;
Humans
;
Oximetry
;
instrumentation
;
Oxygen
;
analysis
10.Clinical Application of Near-Infrared Spectroscopy in Neonates
Neonatal Medicine 2019;26(3):121-127
The incidence of cerebral palsy has not decreased despite advances in neonatal care. Preterm infants are at a high risk of cerebral palsy. Moreover, preterm infants might experience permanent neurological sequelae due to injury in the preterm brain. Although the etiology of preterm brain injury is not fully understood, preterm brain injury is strongly associated with abnormal cerebral perfusion and oxygenation. Monitoring systemic blood pressure or arterial oxygen saturation using pulse oximetry is not enough to guarantee proper cerebral perfusion or oxygenation. Early detection of improper cerebral perfusion can prevent irreversible cerebral damage. To decrease brain injury through the early detection of under-perfusion and deoxygenation, other diagnostic modalities are needed. Near-infrared spectroscopy can continuously and noninvasively monitor regional oxygen saturation (rSO₂), which reflects the perfusion and oxygenation status of tissues at bedside. Near-infrared spectroscopy represents a balance between tissue oxygen supply and demand. Cerebral rSO₂ monitoring has been used most frequently in neonatal cardiac surgery to monitor cerebral oxygenation and prevent hypoxic damage or shock. Recently, cerebral, renal, or splanchnic rSO₂ in neonates is frequently monitored. The progression of a disease, brain injury, and death can be prevented by detecting changes in rSO₂ values using near-infrared spectroscopy. In this article, the basic principles, usefulness, and applications of near-infrared spectroscopy in neonates are discussed.
Blood Pressure
;
Brain
;
Brain Injuries
;
Cerebral Palsy
;
Cerebrovascular Circulation
;
Humans
;
Incidence
;
Infant, Newborn
;
Infant, Premature
;
Oximetry
;
Oxygen
;
Perfusion
;
Shock
;
Spectroscopy, Near-Infrared
;
Splanchnic Circulation
;
Thoracic Surgery

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