使用碳纳米管传感器检测睡眠呼吸障碍预测肺部手术后并发症。

0 CARDIAC & CARDIOVASCULAR SYSTEMS
Yasuhiro Nakashima, Masashi Kobayashi, Ayaka Asakawa, Katsutoshi Seto, Hironori Ishibashi, Shiro Sonoda, Tomoya Tateishi, Meiyo Tamaoka, Yasunari Miyazaki, Koshiro Okumoto, Haruka Horiuchi, Yoshikazu Nakajima, Kenichi Okubo
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引用次数: 0

摘要

目的:睡眠呼吸障碍显著影响围手术期预后;然而,它仍然经常被诊断出来。我们旨在评估一种新型碳纳米管传感器系统用于检测术后呼吸异常的效用,并研究其与胸外科术后并发症的关系。方法:在这项前瞻性研究中,86例解剖性肺切除术后未诊断为阻塞性睡眠呼吸暂停的患者从术后立即到术后第一天使用碳纳米管传感器进行监测。根据多导睡眠描记术中使用的标准低通气标准,将呼吸异常定义为与基线相比峰值传感器信号下降等于或大于30%,持续时间超过10秒。采用Fisher精确检验和Mann-Whitney u检验比较患者特征和并发症。多因素logistic回归确定了主要并发症的预测因素。结果:23例(26.7%)患者出现异常呼吸事件(睡眠呼吸障碍)。该组男性比例较高(87%比61.9%,p = 0.035),插管困难(42.1%比13.5%,p = 0.018),除全身麻醉外,更频繁地接受硬膜外麻醉(65.2%比36.5%,p = 0.027)。多因素分析发现,睡眠呼吸障碍是主要并发症(Clavien-Dindo分级≥3;优势比4.41,95%可信区间1.14-13.8,p = 0.011)和长时间漏气(优势比15.6,95%可信区间2.39-102,p = 0.004)的独立预测因子。结论:碳纳米管传感器显示出检测胸外科手术后未确诊的睡眠呼吸障碍的潜力,这与主要并发症的风险增加独立相关,特别是长时间的漏气。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Detection of Sleep-Disordered Breathing Using Carbon Nanotube Sensors Predicts Complications After Lung Surgery.

Detection of Sleep-Disordered Breathing Using Carbon Nanotube Sensors Predicts Complications After Lung Surgery.

Detection of Sleep-Disordered Breathing Using Carbon Nanotube Sensors Predicts Complications After Lung Surgery.

Detection of Sleep-Disordered Breathing Using Carbon Nanotube Sensors Predicts Complications After Lung Surgery.

Objectives: Sleep-disordered breathing significantly affects perioperative outcomes; however, it remains frequently undiagnosed. We aimed to evaluate the utility of a novel carbon nanotube sensor system for detecting postoperative breathing abnormalities and investigated its association with postoperative complications following thoracic surgery.

Methods: In this prospective study, 86 patients who underwent anatomical lung resection without previously diagnosed obstructive sleep apnoea were monitored using carbon nanotube sensors from the immediate postoperative period through the first postoperative day. Abnormal breathing was defined as an ≥30% reduction in the peak sensor signal from baseline lasting more than 10 s, in accordance with standard hypopnea criteria used in polysomnography. Patient characteristics and complications were compared using Fisher's exact and Mann-Whitney U test. Multivariate logistic regression identified predictors of major complications.

Results: Twenty-three patients (26.7%) exhibited abnormal breathing events (sleep-disordered breathing). This group had a higher proportion of males (87% vs 61.9%, P = .035), had more difficult intubation (42.1% vs 13.5%, P = .018), and more frequently received epidural anaesthesia in addition to general anaesthesia (65.2% vs 36.5%, P = .027). Multivariate analysis identified sleep-disordered breathing as an independent predictor of major complications (Clavien-Dindo grade ≥3; odds ratio 4.41, 95% CI 1.14-13.8, P = .011) and prolonged air leakage (odds ratio 15.6, 95% CI 2.39-102, P = .004).

Conclusions: The carbon nanotube sensor showed potential for detecting undiagnosed sleep-disordered breathing after thoracic surgery, independently associated with increased risk of major complications, particularly prolonged air leakage.

Clinical trial registration: UMIN-CTR (https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000035066). Trial number: UMIN000031533.

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