Open AccessCan We Assess Pulsus Paradoxus through Polysomnography in a Patient with Chronic Obstructive Pulmonary Disease and Sleep-Disordered Breathing?
Author(s) -
César Liendo,
A Dalal,
E Hinds,
Samreena Sara,
Oleg Chernyshev,
Swathi Nutakki,
Jorge Rey de Castro,
Andrew L. Chesson
Publication year - 2016
Publication title -
journal of clinical sleep medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.529
H-Index - 92
eISSN - 1550-9397
pISSN - 1550-9389
DOI - 10.5664/jcsm.5902
Subject(s) - polysomnography , medicine , respiratory disturbance index , photoplethysmogram , obstructive sleep apnea , cardiology , non rapid eye movement sleep , pulse oximetry , anesthesia , sleep and breathing , hypoxemia , breathing , hypopnea , apnea , ophthalmology , filter (signal processing) , computer science , computer vision , eye movement
Pulsus paradoxus (PP) is a decrease in systolic blood pressure greater than 10 mm Hg during inspiration that occurs in various medical conditions. Using polysomnography pulse oximetry signal, photoplethysmography variations of the amplitude of the pulse pressure within the respiratory cycle were observed. There is a proportional relationship between the changes of inspiratory waveform values and the generated PP. A 59-year-old male underwent polysomnography that showed sleep hypoxemia, obstructive sleep-disordered breathing (apnea hypopnea index [AHI] = 5.1and respiratory disturbance index [RDI] = 87.9), with variations of pulse pressure induced primarily by inspiration. The highest variations in the pulse wave were observed in NREM sleep during obstructive respiratory events and in biocalibration during nasal breathing. The lowest variations occurred after the correction of inspiratory obstructive events and during biocalibration when asked to hold his breath.
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