OSAS respiratory event index : REI

Transcription

1 OSAS NO FENOFENO NO NO OSASFENO NO OSAS NO FENO FENO NO NO REI severe CPAP NO OSAS nitric oxide : NO NO fractional exhaled nitric oxide : FENO inhaled corticosteroids : ICS FENO NO synthase ; NOS NOS NO inos inos NO FENO obstructive sleep apnea syndrome : OSAS OSAS respiratory event index : REI OSAS FENO NO FENO OSAS OSAS NO OSAS BMIbody mass index Type 3 portable monitorpmsas 2100, Nihon Kohden, Tokyo, Japan REI REI mild moderate severe FENO 221

2 Patients characteristics Mild15 n28 REI Moderate n23 Severe30 n17 Agey.o. GenderM:F BMI JESS Time with SpO90 nadir SpO mean SpO 3%ODI/hour Smoking historypack years FEV1of predicted FVCof predicted FEV/FVC REI ; respiratory event indexbmi ; body mass indexjess ; Japanese version of the Epworth Sleepiness ScaleODI ; oxygen desaturation indexfev ; forced expiratory volume in 1 secondfvc ; forced vital capacity P 005 vs. Mild group P 001vs. Mild group P 001vs. Moderate group FENO Aerocrine FENO NIOX MINO FENO FENO Oral FENO FENONasal FENO FENO NIOX MINO OptiChamber Diamond Philips/Respironics FENO FENO NONasal cavity NO ; NCNO continuous positive airway pressure : CPAPCPAP CPAP FENO Oneway ANOVA with multiple comparisons Wilcoxon signed rank test P 005 REI FENO mild moderate severe BMI SpO2SpO2 nadir SpO2mean SpO2oxygen desaturation indexodi forced vital capacityfvc severe NO FENO severe NO ppbmild ppbmoderate ppbsevere FENO CPAP FENO CPAP FENO NO FENO NO 222

3 OSAS NO 30 2 a. NO b. FENO c. FENO 1 REI FENO REI mild moderate severe NO FENO FENO P 005 P 001vs. Mild P 005 P 001vs. Moderate a. NO b. FENO c. FENO 2 CPAP FENO NO FENO FENO CPAP ppb399246ppb FENO OSAS NO OSAS NO FENO CPAP FENO 1020ppb FENO 50ppb OSAS FENO mild mild ppbmoderate ppbsevere ppb FENO 20ppb OSAS FENO REI30 severe SpO2 NO inos NO inos NO FENO NO OSA NO FENO FENO NO NO FENO FENO FENO OSAS 223

4 30 2 FENO OSAS FENO OSAS NO FENO NO OSAS OSAS FeNO Michels Dde SRodrigues Ada MNakanishi Met al Nasal Involvement in Obstructive Sleep Apnea SyndromeInternational Journal of Otolaryngology AiPing ChuaLoutfi SOmar Aet allong Term Continuous Positive Airway Pressure Therapy Normalized High Exhaled Nitric Oxide Levels in Obstructive Sleep ApneaJ Clin Sleep Med 2013 ; Marina PetrosyanEleni PerrakiDavina Simoeset al Exhaled breath markers in patients with obstructive sleep ApnoeaSleep Breath Schwab RJBadr SMEpstein LJet alan official American Society statementcontinuous positive airway pressure adherence tracking systemsthe optimal monitoring strategies and outcome measures in adultsam J Respir Crit Care Med Takeno SNoda NHirakawa KMeasurements of Nasal Fractional Exhaled Nitric Oxide with a Handheld Device in Patients with Allergic RhinitisRelation to Cedar Pollen Dispersion and Laser SurgeryAllergology International Christopher OJames AWilliam Iet alexhaled Pentane and Nitric Oxide Levels in Patinets With Obstructive Sleep ApneaCHEST

5 OSAS NO 30 2 Clinical application of the nasal cavity nitric oxide in patients with obstructive sleep apnea syndrome Risaki Kawachi, Yoshiki Kobayashi, Hisashi Ooka Akira Kanda, Mikiya Asako, Hiroshi Iwai and Hirotaka Yasuba Department of OtorhinolaryngologyHead and neck surgery, Kansai Medical University Department of Allergy and Respiratory Medicine, Mitsubishi Kyoto Hospital Ooka clinic Inari clinic Recently, fractionated exhaled nitric oxidefenois being clinically used as a marker for disease diagnosis or an activity indicator for airway inflammatory diseases such as asthma. FENO reflects nitric oxideno, which is released from the airway epithelium, especially the paranasal sinus, due to upper airway inflammation and oxidative stress. Therefore, FENO is also associated with NO levels in the nasal cavity. Obstructive sleep apnea syndromeosasis caused partly due to nasal obstruction and fluctuation of the airflow, suggesting that FENO, especially nasal cavity NO, could be associated with the clinical condition in patients with OSAS. In this study, we evaluated nasal cavity NO for 68 patients suspected of having OSAS. We measured both nasal FENO and oral FENO and defined the nasal cavity NO as the difference between the twonasal FENOoral FENO. Nasal cavity NO levels were significantly elevated in patients with severe OSASrespiratory event index of 30 or moreand reduced after continuous positive airway pressure therapy. These findings indicate that nasal cavity NO levels might be linked to the condition of patients with OSAS and might be clinically used as a marker of disease activity. Key words : FENO, nasal cavity NO, OSAS 225