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High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study

Obstructive sleep apnea (OSA) is associated with increasing risk of recurrent stroke and mortality. Nasogastric tubes used by dysphagic stroke patients may interfere with nasal continuous positive airway pressure (CPAP) due to air leakage. This study was evaluated the effects and short-term tolerabi...

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Autores principales: Ho, Chien-Hui, Chen, Chia-Ling, Yu, Chung-Chieh, Yang, Yao-Hung, Chen, Chung-Yao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244586/
https://www.ncbi.nlm.nih.gov/pubmed/32444630
http://dx.doi.org/10.1038/s41598-020-65335-z
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author Ho, Chien-Hui
Chen, Chia-Ling
Yu, Chung-Chieh
Yang, Yao-Hung
Chen, Chung-Yao
author_facet Ho, Chien-Hui
Chen, Chia-Ling
Yu, Chung-Chieh
Yang, Yao-Hung
Chen, Chung-Yao
author_sort Ho, Chien-Hui
collection PubMed
description Obstructive sleep apnea (OSA) is associated with increasing risk of recurrent stroke and mortality. Nasogastric tubes used by dysphagic stroke patients may interfere with nasal continuous positive airway pressure (CPAP) due to air leakage. This study was evaluated the effects and short-term tolerability of high-flow nasal cannula (HFNC) therapy for OSA in stroke patients with nasogastric intubation. The HFNC titration study was performed in post-acute ischemic stroke patients with nasogastric intubation and OSA. Then, participants were treated with HFNC therapy in the ward for one week. Eleven participants (eight males) who were all elderly with a median age of 72 (IQR 67–82) years and a body mass index of 23.5 (IQR 22.0–26.6) completed the titration study. The HFNC therapy at a flow rate up to 50~60 L/min significantly decreased the apnea-hypopnea index from 52.0 events/h (IQR 29.9–61.9) to 26.5 events/h (IQR 3.3–34.6) and the total arousal index from 34.6 (IQR 18.6–42.3) to 15.0 (IQR 10.3–25.4). The oxygen desaturation index was also significantly decreased from 53.0 events/h (IQR 37.0–72.8) to 16.2 events/h (IQR 0.8–20.1), accompanied by a significant improvement in the minimum SpO(2) level. Finally, only three participants tolerated flow rates of 50~60 L/minute in one-week treatment period. Conclusively, HFNC therapy at therapeutic flow rate is effective at reducing the OSA severity in post-acute ischemic stroke patients with nasogastric intubation. Owing to the suboptimal acceptance, HFNC might be a temporary treatment option, and CPAP therapy is suggested after the nasogastric tube is removed.
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spelling pubmed-72445862020-05-30 High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study Ho, Chien-Hui Chen, Chia-Ling Yu, Chung-Chieh Yang, Yao-Hung Chen, Chung-Yao Sci Rep Article Obstructive sleep apnea (OSA) is associated with increasing risk of recurrent stroke and mortality. Nasogastric tubes used by dysphagic stroke patients may interfere with nasal continuous positive airway pressure (CPAP) due to air leakage. This study was evaluated the effects and short-term tolerability of high-flow nasal cannula (HFNC) therapy for OSA in stroke patients with nasogastric intubation. The HFNC titration study was performed in post-acute ischemic stroke patients with nasogastric intubation and OSA. Then, participants were treated with HFNC therapy in the ward for one week. Eleven participants (eight males) who were all elderly with a median age of 72 (IQR 67–82) years and a body mass index of 23.5 (IQR 22.0–26.6) completed the titration study. The HFNC therapy at a flow rate up to 50~60 L/min significantly decreased the apnea-hypopnea index from 52.0 events/h (IQR 29.9–61.9) to 26.5 events/h (IQR 3.3–34.6) and the total arousal index from 34.6 (IQR 18.6–42.3) to 15.0 (IQR 10.3–25.4). The oxygen desaturation index was also significantly decreased from 53.0 events/h (IQR 37.0–72.8) to 16.2 events/h (IQR 0.8–20.1), accompanied by a significant improvement in the minimum SpO(2) level. Finally, only three participants tolerated flow rates of 50~60 L/minute in one-week treatment period. Conclusively, HFNC therapy at therapeutic flow rate is effective at reducing the OSA severity in post-acute ischemic stroke patients with nasogastric intubation. Owing to the suboptimal acceptance, HFNC might be a temporary treatment option, and CPAP therapy is suggested after the nasogastric tube is removed. Nature Publishing Group UK 2020-05-22 /pmc/articles/PMC7244586/ /pubmed/32444630 http://dx.doi.org/10.1038/s41598-020-65335-z Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Ho, Chien-Hui
Chen, Chia-Ling
Yu, Chung-Chieh
Yang, Yao-Hung
Chen, Chung-Yao
High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title_full High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title_fullStr High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title_full_unstemmed High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title_short High-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
title_sort high-flow nasal cannula ventilation therapy for obstructive sleep apnea in ischemic stroke patients requiring nasogastric tube feeding: a preliminary study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7244586/
https://www.ncbi.nlm.nih.gov/pubmed/32444630
http://dx.doi.org/10.1038/s41598-020-65335-z
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