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Conventional overnight polysomnography (PSG) used to determine the respiratory behaviour during sleep can be a complex and expensive procedure. Pulse transit time analysis (PTT) has shown potential to detect obstructive apnoeic and hypopnoeic events (OE) in adults. Due to abnormalities in central ventilatory control, recurring OE may occur. This study was undertaken to determine the potential of PTT to differentiate responses during upper airway obstruction in the paediatric population. This preliminary study included 11 children (10 male; aged 7.5 +/- 3.8 year) recruited to investigate PTT trend during single and recurrent OE. PTT measurements were evaluated against the corresponding PSG results pre-scored by two blinded observers. A total of 110 valid OE (47 single and 63 recurrent) were observed during these PSG studies. There were distinct PTT responses observed for these two types of OE with respect to those of tidal breathing (P < 0.05). For the tidal breathing events, the mean absolute standard deviation (SD) and maximal percentage (%) decrease (MAX) were 7.71 ms and 3.88% respectively. For the recurrent OE, the absolute SD, SD (%) and MAX were 52.21 ms, 8.52% and 55.08% accordingly while for the single OE, the absolute SD, SD (%) and MAX were 12.23 ms, 5.27% and 13.56% respectively. The findings herein can suggest that PTT can be a valuable clinical tool in the paediatric respiratory sleep studies.
Conventional overnight polysomnography (PSG) used to determine the respiratory behaviour during sleep can be a complex and expensive procedure. Pulse transit time analysis (PTT) has shown potential to detect obstructive apnoeic and hypopnoeic events (OE) in adults. Due to abnormalities in central ventilatory control, recurring OE may occur. This study was undertaken to determine the potential of PTT to differentiate responses during upper airway obstruction in the paediatric population. This preliminary study included 11 children (10 male; aged 7.5 +/- 3.8 year) recruited to investigate PTT trend during single and recurrent OE. PTT measurements were evaluated against the corresponding PSG results pre-scored by two blinded observers. A total of 110 valid OE (47 single and 63 recurrent) were observed during these PSG studies. There were distinct PTT responses observed for these two types of OE with respect to those of tidal breathing (P < 0.05). For the tidal breathing events, the mean absolute standard deviation (SD) and maximal percentage (%) decrease (MAX) were 7.71 ms and 3.88% respectively. For the recurrent OE, the absolute SD, SD (%) and MAX were 52.21 ms, 8.52% and 55.08% accordingly while for the single OE, the absolute SD, SD (%) and MAX were 12.23 ms, 5.27% and 13.56% respectively. The findings herein can suggest that PTT can be a valuable clinical tool in the paediatric respiratory sleep studies.
Respiratory uptake was investigated for 10 polar organic solvents with high blood/air partition coefficients (lambda(blood/air)): ethyl acetate (lambda(blood/air), 77), methyl iso-butyl ketone (90), methyl acetate (90), methyl propyl ketone (150), acetone (245), iso-pentyl alcohol (381), iso-propyl alcohol (848), methyl alcohol (2590), ethylene glycol monobutyl ether (EGBE, 7970), and propylene glycol monomethyl ether (PGME, 12380). Test-air concentrations (Cinh) were 25 to 200 ppm. Four healthy male volunteers inhaled the test air for 10 min at rest and then room air for 5 min. The percentage of solvent in the end-exhaled air and in the mixed-exhaled air increased after the start of the test-air respiration, and reached a quasi-steady-state level within a few min. The speeds of these increases at the start of the test-air respiration became lower as lambda(blood/air) increased. The mean uptakes (U) for the last five min of the test air respiration were 67.3, 52.9, 60.4, 53.0, 52.6, 63.0, 60.3, 60.8, 79.7, and 81.3%, respectively, for ethyl acetate, methyl iso-butyl ketone, methyl acetate, methyl propyl ketone, acetone, iso-pentyl alcohol, iso-propyl alcohol, methyl alcohol, EGBE and PGME. Thus, U values of the alcohols were higher than those of the ketones and lower than the glycol ethers. The overall view, except for esters, showed that U increased with lambda(water/air) increases. This tendency can be explained by a hypothesis that solvent absorbed in the mucus layer of the respiratory tract is removed by the bronchial blood circulation. U values of ethyl acetate and methyl acetate were higher than those of methyl iso-butyl ketone and methyl propyl ketone, though the lambda(blood/air) values of these esters were nearly equal to those of the ketones. For the respiration of the esters, their metabolites, ethyl alcohol and methyl alcohol, were detected in the exhaled air. The exhalation percentage of the metabolites increased after the start of test-air respiration and reached a quasi-steady-state level of 2 and 3%, respectively, by the 5th min. These data suggest that removal of the solvent via metabolism in the wall tissue of the respiratory tract plays an important role for the esters.
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