[Acute hypercapnic respiratory failure in patients with sleep apneas].
BACKGROUND
Acute hypercapnic respiratory failure (AHRF) is a serious condition observed in some patients with sleep apnea-hypopnea syndrome (SAHS). The objective of the present study was to study the clinical characteristics of SAHS patients who develop AHRF and their prognosis.


METHODS
A total of 70 consecutive SAHS patients who survived an AHRF episode and 70 SAHS patients paired by age with no previous history of AHRF were prospectively studied and followed up for 3 years.


RESULTS
The deterioration of lung function due to obesity or concomitant chronic obstructive pulmonary diseases (COPD) was common in SAHS patients with AHRF. In the multivariate analysis, the risk factors associated with AHRF were baseline PaO(2,) the theoretical percentage value of the forced vital capacity, alcohol consumption, and benzodiazepines. The mortality during follow up was higher among patients who had AHRF than in the control group. The main cause of death was respiratory, and the coexistence of COPD was identified as a mortality risk factor.


CONCLUSIONS
The development of AHRF in SAHS patients is associated with a deterioration in lung function and with alcohol and benzodiazepine consumption. The patients had a higher mortality after the AHRF episode, mainly a respiratory cause. New studies are required that evaluate the different available therapeutic options in these patients.
Sampol
Gabriel
G
Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, España. gsampol@vhebron.net
Rodés
Gloria
G
Ríos
José
J
Romero
Odile
O
Lloberes
Patrícia
P
Morell
Ferran
F
D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology*; D012891:Sleep Apnea Syndromes / Q000150:complications*