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The Effect of Upper Airway Surgery on Loop Gain in Obstructive Sleep Apnea

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机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Capital Med Univ, Beijing Tongren Hosp, Clin Ctr OSAHS, Beijing, Peoples R China [3]Capital Med Univ, Key Lab Otolaryngol Head & Neck Surg, Minist Educ China, Beijing, Peoples R China [4]Univ Calif San Diego, Div Pulm Crit Care & Sleep Med, San Diego, CA 92103 USA [5]Beijing Tsinghua Changgung Hosp, Dept Otolaryngol Head & Neck Surg, 168 Litang Rd, Beijing, Peoples R China [6]Brigham & Womens Hosp, Div Sleep Med, 75 Francis St, Boston, MA 02115 USA [7]Harvard Med Sch, Boston, MA 02115 USA
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关键词: hypoxemia loop gain lung obstructive sleep apnea upper airway surgery ventilatory control

摘要:
Study Objectives: Controversy exists as to whether elevated loop gain is a cause or consequence of obstructive sleep apnea (OSA). Upper airway surgery is commonly performed in Asian patients with OSA who have failed positive airway pressure therapy and who are thought to have anatomical predisposition to OSA. We hypothesized that high loop gain would decrease following surgical treatment of OSA due to reduced sleep apnea severity. Methods: Polysomnography was performed preoperatively and postoperatively to assess OSA severity in 30 Chinese participants who underwent upper airway surgery. Loop gain was calculated using a validated clinically-applicable method by fitting a feedback control model to airflow. Results: Patients were followed up for a median (interquartile range) of 130 (62, 224) days after surgery. Apnea-hypopnea index (AHI) changed from 60.8 (33.7, 71.7) to 18.4 (9.9, 42.5) events/h (P < .001). Preoperative and postoperative loop gain was 0.70 (0.58, 0.80) and 0.53 (0.46, 0.63) respectively (P < .001). There was a positive association between the decrease in loop gain and the improvement of AHI (P = .025). Conclusions: High loop gain was reduced by surgical treatment of OSA in our cohort. These data suggest that elevated loop gain may be acquired in OSA and may provide mechanistic insight into improvement in OSA with upper airway surgery.

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学
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出版当年[2017]版:
Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Capital Med Univ, Beijing Tongren Hosp, Clin Ctr OSAHS, Beijing, Peoples R China [3]Capital Med Univ, Key Lab Otolaryngol Head & Neck Surg, Minist Educ China, Beijing, Peoples R China [4]Univ Calif San Diego, Div Pulm Crit Care & Sleep Med, San Diego, CA 92103 USA
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tongren Hosp, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China [2]Capital Med Univ, Beijing Tongren Hosp, Clin Ctr OSAHS, Beijing, Peoples R China [3]Capital Med Univ, Key Lab Otolaryngol Head & Neck Surg, Minist Educ China, Beijing, Peoples R China [5]Beijing Tsinghua Changgung Hosp, Dept Otolaryngol Head & Neck Surg, 168 Litang Rd, Beijing, Peoples R China [*1]Sleep Medicine Center, Dongjiaominxiang 1#, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China [*2]No. 168 Litang Road, Beijing Tsinghua Changgung Hospital, Department of Otolaryngology Head and Neck Surgery, Beijing, China
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