Prevalence of obstructive sleep apnea syndrome of the patients who has the diagnosis of interstitial lung disease and symptoms of sleep-related breathing disorders

Amaç: İnterstisyel akciğer hastalığı (İAH) kronik hastalığa bağlı stres, solunum anormallikleri ve tedavi yan etkileri nedeniyle uyku bozukluklarına yatkındırlar.Çalışmamızda İAH hastalarında uyku kalitesi ile uyku bozuklukları arasındaki ilişkiyi ve obstruktif uyku apne sendromu (OUAS) olasılığını araştırmayı planladık. Gereç ve Yöntem: Polikliniğimizde İAH nedeniyle takipte olan 52 hasta çalışmaya alındı. Hastalara Epworth Uykululk Skoru (EUS) ve Pitsburgh Uyku Kalite İndeksi (PUKİ) uygulandı. Basit spirometri ve difüzyon testi yapıldı. EUS `u 10 ve üzerinde olan 27 hastaya polisomnografi (PSG) uygulandı. EUS ve PUKİ'ye göre subjektif uykululuk ve uyku kaliteleri ile PSG uygulananlarda ölçülen objektif parametreler karşılaştırıldı. Bulgular: Gündüz uykululuğu olan ve olmayan hastalar arasında demografik özellikler, vücut kitle indeksi, immunsupresif ilaç kullanımı,spirometri ve difüzyon testi ölçümleri, sigara kullanımları, PUKİ global puanı ve alt bileşenleri açısından farklılık gözlenmedi. %44,2'sinde PUKİ uyku kalitesinin kötü olduğu gözlemlendi. Ancak PSG yapılan 27 hastanın PUKI global puanı ve alt bileşenlerinin AHI, evre 1 uyku latensi, uyku etkinliği veya nokturnal desaturasyonla ilişki olmadığı saptandı. Evre 1 uyku süresinin arttığı; evre 2-3 ve REM sürelerinin azaldığı saptandı. Nokturnal hipoksemi belirginleştikçe hastaların uyanma sayısının, restriksiyon ağırlığının arttığı; uyku etkinliğinin ise azaldığı izlendi. OUAS oranı %70 olarak bulundu. AHİ'nin REM döneminde ve supine poziyonda belirginleştiği, FEV1-FVC yüzdesi ile negatif korelasyon gösterdiği izlendi. Sonuç: İAH hastalarında gündüz hipoksemisi olmasa da restriksiyon ağırlığı ile ilişkili nokturnal hipokseminin ve OUAS olabileceği ve buna bağlı olarak da uyku kalitesinin etkilenebileceği gözlendi. Bu nedenle, İAH hastalarının gündüz uykululuğu ve uyku etkinliği açısından değerlendirilmesi; semptomatik hastaların uykuda solunum bozukluğu açısından tetkik edilmesi sonucuna varıldı. Aim: Patients with ILD are at risk for sleep disorders due to chronic disease-relatedöstress, respiratory abnormalities and adverse effects of treatment. We aimed to determine the relationship between the quality of sleep, sleep disordered breathing and the insidence of obstructive sleep apnea in these patients. Materials- methods: 52 patients with ILD were enrolled in the study. Pittsburgh Sleep Quality Index(PSQI) and Epworth Sleepiness Score(ESS) were applied. All patients underwent spirometry and diffusion test. Polysomnography was performed to 27 patients who had an ESS >=10. Subjective parameters of sleepiness and sleep quality compered with the objective parameters measured by PSG. Result: Patients were classified according to daytime sleepiness. Demographic characteristics, body mass index, immunesuppressive medication, spirometry and diffusion measurements, smoking habits, the sub-components of PSQI and global score didn?t differ between groups. Subjective sleep quality was poor in 44% of patients. PSQI global score and sub-components weren?t correlated with AHI, stage 1 latency, sleep efficiency and nocturnal desaturation. We found increased stage 1 sleep and decreased stage 2-3 and REM sleep.Nocturnal hypoxemia was determined related with severity of restriction, arousals and sleep efficiency. Nineteen (70%) of subjects were diagnosed with OSAS. AHI was negatively correlated with percentage of FEV1-FVC and sleep efficiency and was evident during REM sleep and supine position. Conclusion: Although patients with ILD don?t have daytime hypoxemia; nocturnal hypoxemia estimated by severity of restriction can contribute to apnea- hypopnea episodes. Therefore ILD patients must be evaluated for daytime sleepiness, sleep quality and inspected for sleep-related breathing disorders

Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units

Background: There are limited data on the long-term outcomes of COVID-19 from different parts of the world. Aims: To determine risk factors of 90-day mortality in critically ill patients in Turkish intensive care units (ICUs), with respiratory failure. Study design: Retrospective, observational cohort. Methods: Patients with laboratory-confirmed COVID-19 and who had been followed up in the ICUs with respiratory failure for more than 24 hours were included in the study. Their demographics, clinical characteristics, laboratory variables, treatment protocols, and survival data were recorded. Results: A total of 421 patients were included. The median age was 67 (IQR: 57-76) years, and 251 patients (59.6%) were men. The 90-day mortality rate was 55.1%. The factors independently associated with 90-day mortality were invasive mechanical ventilation (IMV) (HR 4.09 [95% CI: [2.20-7.63], P2 mmol/L (2.78 [1.93-4.01], P= 60 years (2.45 [1.48-4.06)], P= 600 mL/day (1.68 [1.21-2.34], P=.002), PaO2/FiO(2) ratio of = 1 (1.42 [1.00-2.02], P=.050). Conclusion: Long-term mortality was high in critically ill patients with COVID-19 hospitalized in intensive care units in Turkey. Invasive mechanical ventilation, lactate level, age, cardiac arrhythmia, vasopressor therapy, positive fluid balance, severe hypoxemia and ECOG score were the independent risk factors for 90-day mortality.WOS:0007008536000072-s2.0-85115428262PubMed: 3455841

TÜRKIYE’DE YOĞUN BAKIM ÜNITELERINDE VENTILATÖR ILIŞKILI PNÖMONIYI ÖNLEMEK IÇIN ALINAN GÜNCEL ÖNLEMLER: TÜRK TORAKS DERNEĞI SOLUNUM YETMEZLIĞI VE YOĞUN BAKIM ÇALIŞMA GRUBU NOKTA PREVALANS ÇALIŞMASI

Objectives: The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain and life quality of patients who underwent pulmonary resection