Capnography screening for sleep apnea in patients with acute stroke

Sleep apnea syndrome (SAS) is a prominent clinical feature in acute stroke patients. Diagnosis is usually established by polysomnography or cardio-respiratory polygraphy (CRP). Both diagnostic procedures produce high costs, are dependent on the access to a specialized sleep laboratory, and are poorl...

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Bibliographic Details
Published in:Neurological research (New York) 2005-01, Vol.27 (1), p.83-87
Main Authors: Dziewas, Rainer, Hopmann, Benjamin, Humpert, Marius, Böntert, Matthias, Dittrich, Ralf, Lüdemann, Peter, Young, Peter, Ringelstein, E. Bernd, Nabavi, Darius G.
Format: Article
Language:English
Subjects:
Aged
CAPNOGRAPHY
Capnography - methods
Female
Humans
Male
Mass Screening
Middle Aged
Monitoring, Physiologic
Polysomnography - methods
Predictive Value of Tests
Prospective Studies
Regression Analysis
Reproducibility of Results
Respiration
Retrospective Studies
Sensitivity and Specificity
Severity of Illness Index
SLEEP APNEA SYNDROME
Sleep Apnea Syndromes - diagnosis
Sleep Apnea Syndromes - etiology
STROKE
Stroke - complications
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Summary:Sleep apnea syndrome (SAS) is a prominent clinical feature in acute stroke patients. Diagnosis is usually established by polysomnography or cardio-respiratory polygraphy (CRP). Both diagnostic procedures produce high costs, are dependent on the access to a specialized sleep laboratory, and are poorly tolerated by patients with acute stroke. In this study we therefore investigated whether capnography may work as a simple screening tool in this context. In addition to conventional CRP, 27 patients with acute stroke were studied with capnography provided by our standard monitoring system. The trend graphs of the end-tidal CO 2 values (EtCO 2 ) were used to determine the capnography-based estimate of the apnea-hypopnea index (AHI CO2 ). Index events were scored when the EtCO 2 value dropped for > 50% of the previous baseline value. We found that the AHI CO2 correlated significantly with the apnea-hypopnea index measured with conventional CRP (AHI CRP ) (r=0.94; p 5 turned out to be highly predictive of an AHI CRP > 10. According to our findings, routinely acquired capnography may provide a reliable estimate of the AHI CRP . The equipment needed for this screening procedure is provided by the monitoring systems of most intensive care units and stroke units where stroke patients are regularly treated during the first days of their illness. Therefore, early diagnosis of SAS in these patients is made substantially easier.
ISSN:0161-6412
1743-1328
DOI:10.1179/016164105X18359