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Persistent daytime hypercapnia predicts poor prognosis in OSAS undergoing CPAP therapy

Naoko Kawata, Jiro Terada, Koichiro Tatsumi
European Respiratory Journal 2016 48: PA3424; DOI: 10.1183/13993003.congress-2016.PA3424
Naoko Kawata
1Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Jiro Terada
1Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Koichiro Tatsumi
1Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Abstract

Background: Positive airway pressure therapy (PAP) is reported to improve the mortality of OSAS with daytime hypercapnia . However, the data on long-term prognosis in hypercapnic OSAS undergoing CPAP therapy are limited.

Objective: Our study objectives were to investigate the survival and explore prognostic factors in OSAS with daytime hypercapnia undergoing CPAP therapy.

Methods: Thirty-seven patients who were diagnosed OSAS with daytime hypercapnia (PaCO2 > 45mmHg) were enrolled. All of them are treated with CPAP therapy. The patients were divided into 2 groups according to the improvement of PaCO2 by CPAP therapy after 3 months (the change in PaCO2 ≥ 5mmHg; good responder, the change in PaCO2 < 5mmHg; poor responder). Long-term mortality and predictors of survival were evaluated.

Results: During median follow-up of 125 months, All-cause mortality was 33%, in poor responder group to CPAP therapy. In contrast, all of the patients in good responder group survived (log-lank, p = 0.0115). In univariate analysis, patients with PaO2< mmHg and PaCO2>45 mmHg at baseline had poor prognosis (p =0.0013, p <0.0001, respectively). In Cox multivariate analysis, PaCO2 after CPAP therapy was independent predictor of mortality (p = 0.042). In contrast, neither BMI nor results of pulmonary function tests was linked to their survival.

Conclusion: The presence of hypercapnia which is resistant to CPAP therapy predicts poor prognosis in hypercapnic OSAS.

  • Sleep disorders
  • Longitudinal study
  • Copyright ©the authors 2016
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Persistent daytime hypercapnia predicts poor prognosis in OSAS undergoing CPAP therapy
Naoko Kawata, Jiro Terada, Koichiro Tatsumi
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3424; DOI: 10.1183/13993003.congress-2016.PA3424

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Persistent daytime hypercapnia predicts poor prognosis in OSAS undergoing CPAP therapy
Naoko Kawata, Jiro Terada, Koichiro Tatsumi
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3424; DOI: 10.1183/13993003.congress-2016.PA3424
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