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Biomedical subjects

Aiman Tulaimat

Publications and source records attributed to Aiman Tulaimat.

5 recordsLinked to original sources
PubMed2007

Obesity hypoventilation syndrome: prevalence and predictors in patients with obstructive sleep apnea.

Patients with obesity hypoventilation syndrome (OHS) have a lower quality of life, more healthcare expenses, a greater risk of pulmonary hypertension, and a higher mortality compared to eucapnic patients with obstructive sleep apnea (OSA). Despite significant morbidity and mortality associated with OHS, it is often unrecognized and treatment is frequently delayed. The objective of this observational study was to determine the prevalence of OHS in patients with OSA seen at the sleep disorders clinic of a large public urban hospital serving predominantly minority population and to identify clinical--not mechanistic--predictors that should prompt clinicians to measure arterial blood gases. In the first stage, we randomly selected 180 patients referred to our sleep disorders clinic between 2000 and 2004 for suspicion of OSA. From this retrospective random sample we calculated the prevalence of OHS in patients with OSA and identified independent clinical predictors using logistic regression. In the second stage, we prospectively validated these predictors in a sample of 410 consecutive patients referred to the sleep disorders clinic for suspicion of OSA between 2005 and 2006. The prevalence of OHS in patients with OSA was 30% in the retrospective random sample and 20% in the prospective sample. Three variables independently predicted OHS in both samples: serum bicarbonate level (p < 0.001), apnea-hypopnea index (p = 0.006), and lowest oxygen saturation during sleep (p < 0.001). Due to the serious morbidity associated with OHS, we selected a highly sensitive threshold of serum bicarbonate level. A threshold of 27 mEq/l had a sensitivity of 92% and a specificity of 50%. Only 3% of patients with a serum bicarbonate level <27 mEq/l had hypercapnia compared to 50% with a serum bicarbonate > or =27 mEq/l. In conclusion, OHS is common in severe OSA. A normal serum bicarbonate level excludes hypercapnia and an elevated serum bicarbonate level should prompt clinicians to measure arterial blood gases.

Adult↗
PubMed2005

The effect of continuous positive airway pressure on glucose control in diabetic patients with severe obstructive sleep apnea.

Obstructive sleep apnea (OSA) is independently associated with glucose intolerance and insulin resistance, and recent studies have shown that continuous positive airway pressure (CPAP) improves insulin sensitivity. The objective of this study was to describe the change in glycosylated hemoglobin (HbA1c) after treatment with CPAP in patients with type 2 diabetes mellitus and OSA. To test this hypothesis, we performed a retrospective analysis of 38 patients seen in the sleep clinic of an urban public teaching hospital. All patients had OSA and type 2 diabetes mellitus, and their diabetic medication regimen had remained unchanged during the period of CPAP therapy. Sixty-one percent were men, body mass index was 42+/-9.5 kg/m(2), and the Apnea-Hypopnea Index was 53+/-36 per hour. HbA1c before therapy with CPAP was 7.8+/-1.4% and decreased to 7.3+/-1.3% after 134+/-119 days of therapy (p<0.001). Treatment with CPAP leads to a clinically significant drop in HbA1c in patients with type 2 diabetes mellitus and severe OSA.

Blood Glucose↗
PubMed2005

Potassium sorbate reduces gastric colonization in patients receiving mechanical ventilation.

OBJECTIVES: Tube feeding might increase gastric burden of pathogenic bacteria and predispose patients to ventilator-associated pneumonia. We sought to determine whether a tube feeding formula acidified using potassium sorbate could reduce gastric burden of potentially pathogenic bacteria. DESIGN: Prospective, randomized, double-blind trial. SETTING: RML Specialty Hospital, a facility with expertise in weaning patients from prolonged mechanical ventilation. PATIENTS: Thirty patients recovering from prolonged mechanical ventilation. INTERVENTION: Patients were randomized to receive either a standard tube feeding formula (n=14) or a formula acidified using potassium sorbate to a pH of 4.25 (n=16). MEASUREMENTS AND RESULTS: Weekly quantitative cultures of gastric aspirates. The number of colony-forming units (CFUs) per patient was higher in the control than in the treatment group (53%+/-11% vs 9%+/-3.4%, threshold of >or=100,000 CFU/mL fluid, P=.003). The number of organisms isolated in each patient per week was higher among patients receiving standard tube feeding formula than among patients receiving acidified formula (0.91 +/- 0.20 vs 0.13 +/- 0.05 organisms per patient per week, threshold of >or=100,000 CFU/mL fluid, P=.0014). There was no difference in the incidence of gastrointestinal bleeding or ventilator-associated pneumonia between study groups. CONCLUSION: Tube feeding formula acidified using potassium sorbate was well tolerated and reduced gastric bacterial burden in patients recovering from prolonged mechanical ventilation.

Aged↗