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H W Duchna

Publications and source records attributed to H W Duchna.

22 records · Page 2Linked to original sources
PubMed1995

[Sensitivity and specificity of pulse oximetry in diagnosis of sleep-related respiratory disorders].

As there is a great demand for polysomnography, screening tests had to be established in the diagnosis of sleep-related disordered breathing. Oxygen saturation is often used as a main diagnostic criterion of these screening tests. In 207 patients (42 women, 165 men) suspected to suffer from a sleep apnea-syndrome we compared oxygen saturation (pulse oxymetry) with apnea-hypopnea-index (AHI, polysomnography). An AHI > or = 5/h and a minimal oxygen saturation < 90% and/or more than 5 oxygen desaturations/h > or = 4% were regarded as pathological. We found a good correlation of significant oxygen desaturations measured with pulse oxymetry and AHI (r = 0.85). Compared to AHI, pulse oxymetry was seen as a sensitive method (sensitivity 0.97) to recognize sleep apnea-patients. Coincidence of COPD decreased specificity of pulse oxymetry from 0.48 to 0.23 but had no influence on its sensitivity. 13 percent of the patients without further cardiorespiratory disease had a normal AHI (< 5/h) but a pathological pulse oxymetry. We conclude, that pulse oxymetry in combination with a positive case history is a sensitive method to recognize sleep apnea-patients. Not all sleep apnea-patients' can be diagnosed only by regarding AHI without taking oxygen saturation into account.

Adult↗
PubMed1995

[Long-term acceptance of n-CPAP therapy by patients with sleep related respiratory disorders].

The therapeutic effect in application of n-CPAP therapy (nasal continuous positive airway pressure) is dependent on both the acute effect of this therapy and the long-term acceptance and consequent palliation respectively avoidance of sequelae. We present 50 patients (47 male, 3 female) treated with n-CPAP therapy because of severe sleep-related disorders of breathing. All patients had polysomnography, and in addition questionnaires were mailed to all 50 patients in order to get information concerning the symptoms of sleep-related disorders of breathing before and under n-CPAP therapy, mode of therapy and side-effects in application of n-CPAP therapy. Patients were treated for at least three to a maximum of 25 months with n-CPAP (average 10.5 months). Long-term acceptance with n-CPAP was defined as persistent use of n-CPAP during every night for at least five hours. On average continuous positive airway pressure of 8.6 mbar (range 4-18) was effective in normalizing formerly severe pathological respiratory parameters. Apnea-index decreased from 22.8 to 2.17/h on average. Regarding the symptoms of sleep-related disorders of breathing before and under n-CPAP therapy, we saw that almost 100% of our patients complained of the main symptoms of sleep-related disorders of breathing. By regular n-CPAP application a complete reduction of these symptoms could be achieved in nearly 80% of patients. Long-term acceptance of n-CPAP therapy was reported by 78% of our patients who used their n-CPAP device every night for at least five hours.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Bronchial hyperreactivity and obstructive respiratory tract diseases. A 2.8 year follow-up study].

BACKGROUND: Nonspecific bronchial hyperreactivity (BHR) is under discussion as a possible risk factor for the development of chronic obstructive pulmonary disease. METHOD: Within the framework of a prospective study, we investigated the course of the disease in 50 inpatients with BHR, and the clinical symptoms of airways disease (coughing, dyspnea and expectoration) with no manifest airways obstruction at rest (Rt < 3.5 cm H2O/l/s) on admission to the hospital. The unspecific inhalative provocation challenge was carried out with metacholine. The presence of BHR was assumed when the resting respiratory resistance (Rt) of < 3.5 cm H2O/l/s increased to more than 6 cm H2O/l/s. On admission to hospital, all the patients were treated with inhalative bronchodilators and glucocorticosteroids. RESULTS: After an average period of 2.8 years, BHR was no longer measurable in only 7 of the patients (14%), while 28 patients (56%) continued to have a BHR with clinical symptomatology presenting. In 15 patients (30%), manifest airways obstruction at rest, with an average Rt of 6.4 cm H2O/l/s developed. In patients with an uncharacteristic cough, dyspnea and unremarkable lung function parameters at rest, a provocation test should be done to identify BHR. A prognosis can, however, not be established on the basis of a single demonstration of BHR, but only after observation over a longer period.

Adult↗