Scientific article
Review
OA Policy
English

Nocturnal monitoring of home non-invasive ventilation: the contribution of simple tools such as pulse oximetry, capnography, built-in ventilator software and autonomic markers of sleep fragmentation

Published inThorax, vol. 66, no. 5, p. 438-445
Publication date2011
Abstract

Complex respiratory events, which may have a detrimental effect on both quality of sleep and control of nocturnal hypoventilation, occur during sleep in patients treated with non-invasive ventilation (NIV). Among these events are patient-ventilator asynchrony, increases in upper airway resistance (with or without increased respiratory drive) and leaks. Detection of these events is important in order to select the most appropriate ventilator settings and interface. Simple tools can provide important information when monitoring NIV. Pulse oximetry is important to ensure that adequate oxygen saturation is provided and to detect either prolonged or short and recurrent desaturations. However, the specificity of pulse oximetry tracings during NIV is low. Transcutaneous capnography helps discriminate between hypoxaemia related to ventilation/perfusion mismatch and hypoventilation, documents correction of nocturnal hypoventilation and may detect ventilator-induced hyperventilation, a possible cause for central apnoea/hypopnoea and glottic closure. Data provided by ventilator software help the clinician by estimating ventilation, tidal volume, leaks and the rate of inspiratory or expiratory triggering by the patient, although further validation of these signals by independent studies is indicated. Finally, autonomic markers of sympathetic tone using signals such as pulse wave amplitude of the pulse oximetry signal can provide reliable information of sleep fragmentation.

Keywords
  • Capnography/methods
  • Carbon Dioxide/blood
  • Home Care Services
  • Hospital-Based
  • Humans
  • Monitoring
  • Physiologic/methods
  • Oximetry/methods
  • Partial Pressure
  • Positive-Pressure Respiration/methods
  • Sleep Deprivation/therapy
  • Software
Citation (ISO format)
JANSSENS, Jean-Paul, BOREL, Jean-Christian, PÉPIN, Jean-Louis. Nocturnal monitoring of home non-invasive ventilation: the contribution of simple tools such as pulse oximetry, capnography, built-in ventilator software and autonomic markers of sleep fragmentation. In: Thorax, 2011, vol. 66, n° 5, p. 438–445. doi: 10.1136/thx.2010.139782
Main files (1)
Article (Published version)
accessLevelPublic
Identifiers
Journal ISSN0040-6376
191views
234downloads

Technical informations

Creation20/10/2020 14:39:00
First validation20/10/2020 14:39:00
Update16/03/2023 01:15:42
Status update16/03/2023 01:15:42
Last indexation31/10/2024 23:03:14
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack