The effect of CPAP treatment on venous lactate and arterial blood gas among obstructive sleep apnea syndrome patients.
OBJECTIVE
The aim of this observational study was to investigate the influence of continuous positive airway pressure (CPAP) on arterial blood gas and venous lactate, markers of tissue hypoxia, among obstructive sleep apnea syndrome (OSAS) patients, and determine the risk factor of serum lactate and hydrogen ion concentration (PH) in OSAS patients.


METHODS
One-hundred and nine patients with newly diagnosed OSAS were enrolled in the study. All individuals were treated with CPAP for one night. Venous lactate and arterial blood gas were gathered from all subjects in the morning at the end of polysomnography and the next morning after CPAP treatment.


RESULTS
Of the 109 selected subjects, the average lactate level was 2.23 ± 0.59 mmol/L, and the mean PH, PaO2, and PaCO2were 7.380 ± 0.23, 88.14 ± 17.83 mmHg, and 38.70 ± 4.28 mmHg, respectively. Compared to baseline, lactic acid significantly decreased (2.10 ± 0.50 mmol/L, p = 0.03), while PH increased (7.388 ± 0.27, p < 0.05) after CPAP treatment. In addition, neck circumference and the polysomnographic parameters, including apnea-hypopnea index, oxygen desaturation index (ODI), mean oxygen saturation (SpO2), and the percentage of sleep time with SpO2<90 % (TS90 %), positively correlated with lactate, while age correlated negatively with lactate (all p < 0.05). Significantly positive associations were found between age, neck circumference, and PH; furthermore, a negative correlation was found between ODI and PH. Finally, after adjusting for confounding factors, TS90 % was the major contributing predictor for elevated lactate (p < 0.05), and age was a predictor for an increase in PH (p < 0.05).


CONCLUSIONS
The results indicated that CPAP treatment could reduce serum lactate and increase PH in OSAS patients and might alleviate acid-base balance disorders in OSAS. Furthermore, TS90 % was a risk factor for elevated lactate, and age was independently associated with PH.
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Ting
T
Lin
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Jie-Feng
JF
Huang
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China. chang4e@126.com.
Qi-Chang
QC
Lin
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Gong-Ping
GP
Chen
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Bi-Ying
BY
Wang
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Jian-Ming
JM
Zhao
Fujian Provincial Sleep-Disordered Breathing Clinic Center, Laboratory of Respiratory Disease of the Fujian Medical University, Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, No. 20, Chazhong Road, Taijiang District, 350005, Fuzhou, Fujian Province, People's Republic of China.
Jia-Chao
JC
Qi
D000328:Adult; D001784:Blood Gas Analysis; D002681:China; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000628:therapy*
D019344:Lactic Acid
Blood gas analysis; Continuous positive airway pressure; Lactate; Obstructive sleep apnea syndrome
J Int Neuropsychol Soc. 2004 Sep;10(5):772-85
15327723
Sleep. 1991 Dec;14(6):486-95
1798880
Chest. 1993 Sep;104(3):770-4
8365287
Am J Respir Crit Care Med. 1994 Dec;150(6 Pt 1):1738-45
7952642
Neurobiol Aging. 2003 Sep;24(5):753-60
12885583
J Cardiovasc Med (Hagerstown). 2014 May;15(5):402-6
24755667
Respiration. 2009;78(2):141-6
18984944
N Engl J Med. 1993 Apr 29;328(17):1230-5
8464434
Eur Respir J. 1998 Sep;12 (3):658-65
9762796
Med Sci Monit. 2011 Sep;17(9):CR491-7
21873945
Anesth Analg. 2012 Sep;115(3):605-10
22745117
Crit Care. 2010;14(6):R196
21040580
Am J Respir Crit Care Med. 1998 Jan;157(1):144-8
9445292
Eur Respir J. 2008 Oct;32(4):1082-95
18827154
J Physiol. 2004 Jul 1;558(Pt 1):5-30
15131240
Intern Med. 2013;52(3):345-9
23370742
J Clin Sleep Med. 2006 Jan 15;2(1):57-62
17557438
Crit Care. 2002 Aug;6(4):322-6
12225607
Sleep Med. 2004 Mar;5(2):137-45
15033133
South Med J. 2009 Jul;102(7):693-700
19487994
Lancet. 2005 Mar 5-11;365(9462):871-5
15752531
Ann Saudi Med. 2012 Jan-Feb;32(1):37-42
22156638
Physiol Rev. 2010 Jan;90(1):47-112
20086074
Annu Rev Med. 1976;27:465-84
180875
Sleep. 1995 Apr;18(3):172-9
7610313