FORMULAS BRECHA ANIONICA= (Na – Cl + hco3 Osmolaridad serica= 2(Na+K )+ Gluc/18 DEFICIT DE AGUA CORPORAL TOTAL= X PESO. Clinicamente la ATR se caracteriza por una brecha anionica normal, acompanada de anorexia, poliuria, constipacion; la acidosis metabolica hipercloremica es. intoxicación por otros alcoholes como el etilenglicol, la cetoacidosis diabética e intoxicaciones que cursan con brecha anionica elevada como la causada por.
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Descriptive observational study in adults referred for polysomnogram PSG.
Patients with severe OSA had higher desaturation during wakefulness The clinical impact of sleep disorders at this point may be greater than at sea level and should be studied. Sleep apnea, High altitude, Oxygen saturation. Obstructive sleep apnea OSA is a frequent condition , characterized by recurrent respiratory pauses which lead to sleep fragmentation and intermittent desaturation.
For the definition of hypopnea and consequently, for the diagnosis of OSA, oxygen desaturation is involved as one of its components [2,3]. Even though persistent and intermittent nocturnal desaturation had been related with the presence of some consequences of OSA, such as pulmonary hypertension and atherosclerosis , the role that desaturation has on the pathogenesis, development and treatment of pulmonary hypertension in patients with SAHS, is still obscure . It is, therefore, very important to know the SpO 2 behavior during sleep at Bogota’s altitude as an initial step to investigate the role of altitude and the possible clinical repercussions of oxygen desaturation in patients with SAHS and if these findings justify a redefinition of this syndrome at this altitude.
The objective of this study was to describe the oxygen saturation during wakefulness sleep and apneas-hypopneas in adults at an altitude of m. The study was approved by the Ethics Committee of the institution in and the patients approved the realization of the polysomnogram.
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The value of oxygen saturation and the pulse frequency were determined by an average of a 2 s sample. Manual scoring of the records was performed. The sleep stages were classified according to international criteria during the years of study Reschtchaffen and Kales .
The apnea-hypopnea index AHI was defined as the total number of apneas and hypopneas per hour of sleep.
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Patients who received oxygen during the study, the studies for CPAP titration, and those with less than 4 h, were excluded. We used averages and standard deviations for the quantitative variables and the proportions for qualitative variables.
To establish the degree of statistical significance of the different proportions, we used the chi square test. We used the statistical programs SPSS In the group of sleep apnea, Desaturation was larger lower SpO 2 during apnea or hypopnea events for all the severity groups of OSA.
The worst desaturation during REM sleep in patients with sleep apnea has been described and has been related with the duration of apneas during this sleep stage . Some studies have described the behavior of oxygen saturation during sleep. The saturation decreased mildly with age, ranging from With altitude, the saturation values differ, however, the majority of the studies has been performed at more than m.
In six normal subjects, the average SaO2 during sleep were of The studies during sleep in anionic altitudes are few and anionjca performed at simulated altitudes anioniica hypoxia [20,21].
Findings of the majority of studies performed at aninoica are not comparable with the ones of our study, since they were performed after acute exposition to altitude, which can induce the appearance of central apneas and reflect the changes that are detected with an early adaptation .
Rey de Castro et al. In the study group, the majority had intermittent exposition to anionicca altitude. All desaturation indexes measured on the study were lower in central apnea when compared with OSA . In Bogota mthe studies of normal values of PaO 2 have been conducted during wakefulness and involves normal and young subjects .
However, at this altitude, PaO 2 is 60 mmHg, from which the curve of hemoglobin dissociation inclines and small changes of PaO 2 have significant repercussions on SpO 2. The repercussion of intermittent and persistent hypoxia, reflected upon the levels of desaturation in the patients of the study, might be very significant. In this study, we have described the average oxygen saturation. The strengths of this study were the significant number of patients included and that this is as our best knowledge, the first article describing the behavior of oxygen saturation during sleep in individuals with OSA, living at high altitude above mcontributing for better understanding of this pathology among our population and in populations living in similar altitudes.
This study has some limitations: Additionally, we have not analyzed separately the population with diagnostic of hypoventilation, obesity, obstructive pulmonary disease, nor cardiovascular comorbities. Due to the fact that patients with more severe AHI were older and had higher BMI, anionida future studies are dully required to evaluate the impact of these variables upon SpO 2 at Bogota’s altitude, as well as the possible differences that might exist between genders.
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The impact of this upon the development of complications such as pulmonary hypertension in patients with SAHS at this time, is still undetermined.
Epidemiology of obstructive sleep apnea: Chronic intermittent hypoxia induces atherosclerosis. Pulmonary hemodynamics in the obstructive sleep apnea syndrome. Daytime pulmonary hypertension in patients with obstructive sleep apnea. Am Rev Resp Dis ; Eur Respir J ;8: Gasimetria arterial y alveolar en adultos sanos a nivel de Bogota. Acta Med Colomb ;7 6: Gasimetria arterial en adultos jovenes a nivel de Bogota.
Acta Med Colomb ;9 1: Gasimetria arterial en adultos jovenes sanos en Bogota.
Sleep apnea and oxygen saturation in adults at 2640 m above sea level
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Changes in sleep quality of athletes under normobaric hypoxia equivalent to m altitude: J Appl Physiol ; Respiratory events and periodic breathing in cyclists sleeping at m simulated altitude.
Caudwell xtreme everest research group. Arterial blood gases and oxygen content in climbers on mount everest. N Engl J Med ; Prevalence of sleep-disordered breathing in truck drivers at a mine located at high altitude. Sleep Sci ;6 2: Received in December 13 Reviewed in May 8 Accepted em May 14 Home Past Issues Summary Vol. Sleep apnea, Brwcha altitude, Oxygen saturation 1.
Apnea hypopnea index apneas-hypopneas per hour of sleep.
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