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Open AccessArticle

Increasing Hypopnea in Sleep Breathing Disturbance Improves Postoperative Oxygen Saturation in Patients with Very Severe Obstructive Sleep Apnea

1
Department of Otolaryngology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
2
Sleep Center of Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
3
School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
4
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
5
Department of Nursing, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
6
Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi 61363, Taiwan
7
Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
8
Department of Neurology, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
9
Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi 61363, Taiwan
*
Author to whom correspondence should be addressed.
Appl. Sci. 2020, 10(18), 6539; https://doi.org/10.3390/app10186539
Received: 9 August 2020 / Revised: 3 September 2020 / Accepted: 14 September 2020 / Published: 18 September 2020
In patients of very severe obstructive sleep apnea (OSA) with confined framework, reducing volume is difficult to achieve a postoperative apnea-hypopnea index (AHI) qualifying the classical surgical success. However, a higher AHI with a larger part of hypopneas may have similar or even less severity of oxygen (O2) desaturation, compared to a lower index mostly made of apneas. Here, in 27 consecutive enrolled patients, we show that besides the improvement of mean AHI, the multilevel surgery increased hypopnea in AHI from 29.1% to 77.3%, and improves postoperative O2 saturation by reducing desaturation frequency (mean desaturation index decreased from 62.5 to 24.4 events/h) and level (mean oxyhemoglobin saturation of pulse oximetry (SpO2) desaturation cut down from 10.0 to 5.8%). The mean SpO2 improved from 92.3% to 94.7%, and the improvement was positively related to the proportion increase of hypopnea/AHI. The results suggest that the non-framework surgery could help patients with very severe OSA whose AHIs are ≥60 events/h in terms of improving postoperative O2 saturation. Due to the improvement also presented in those not qualified as classical surgical success, further studies are needed to clarify the connection between O2 desaturation and various consequences to reconsider defining a surgical success. View Full-Text
Keywords: palatoplasty; one-stage; comorbidity; retropharynx; maxillomandibular advancement; Continuous Positive Airway Pressure (CPAP) palatoplasty; one-stage; comorbidity; retropharynx; maxillomandibular advancement; Continuous Positive Airway Pressure (CPAP)
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Huang, E.I.; Huang, S.-Y.; Lin, Y.-C.; Lin, C.-M.; Lin, C.-K.; Huang, Y.-C.; Su, J.-A. Increasing Hypopnea in Sleep Breathing Disturbance Improves Postoperative Oxygen Saturation in Patients with Very Severe Obstructive Sleep Apnea. Appl. Sci. 2020, 10, 6539.

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