An overnight increase in CO₂ predicts mortality in sleep disordered breathing

Abstract

An overnight increase in CO2 and evening hypoxaemia are independent mortality predictors in SDB. A low minimum SpO2 identifies patients in whom morning and evening arterial blood gases are beneficial.

Home Mechanical Ventilation in Childhood-Onset Hereditary Neuromuscular Diseases: 13 Years’ Experience at a Single Center in Korea

“…In general, we paid more attention to symptoms, physical exams, chest radiographs, morning blood gases, and the family’s opinion than to other factors when we decided whether to apply HMV for children with NMD. Nocturnal oxygen saturation monitoring plus morning blood gases are usually performed as simple assessments of sleep-disordered breathing in young children with NMD at our center [ 17 , 23 ]. Regular pulmonary function tests and polysomnography for cooperative children with NMD are required for our center to establish more objective indications to reduce the rate of emergent unplanned HMV [ 21 , 24 ].…”

Global warming and increased sleep disordered breathing mortality, rising carbon dioxide levels are a serial pest

“…In this issue, Brillante et al . report on an intriguing retrospective study which suggests that an overnight increase in carbon dioxide levels (>7mm Hg) and evening hypoxemia (PO 2 < 65mm Hg) preceding a diagnostic polysomnogram (PSG) predicted long‐term mortality in sleep disordered breathing 1 …”

“…It seems surprising that while this data series is called consecutive, so few patients had data available for review as 322 patients represent only 1.3 patients/week. The authors describe the reasons for this in Figure 1 1 …”

“…In this issue, Brillante et al report on an intriguing retrospective study which suggests that an overnight increase in carbon dioxide levels (>7mm Hg) and evening hypoxemia (PO2 < 65mm Hg) preceding a diagnostic polysomnogram (PSG) predicted long-term mortality in sleep disordered breathing. 1 It is likely to be a unique study because it is backed by an unusual clinical practice, the collection of evening and early morning arterial blood gases (ABGS) in nearly all patients presenting to the Sleep Laboratory for a diagnostic PSG.…”

“…The authors describe the reasons for this in Figure 1. 1 The rise in PCO2 of >7 mm Hg overnight is not a measurement used clinically, and even if it was, I think it is unlikely that it would be hard to justify routine ABGS on all patients to look for this rise. Should all patients with low resting saturations have a PM and an AM arterial blood gas as the authors suggest?…”