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While Drug Induced Sleep Endoscopy (DISE) in patients with obstructive sleep apnea syndrome (OSAS) apnea and hypopnea occur. Because of the induced phases of apnea in a controlled setting it is possible to evaluate the related pathophysiology of apnea. We plan to correlate the Patient State Index (PSI) and other physiologic parameters with phases of apnea and hypopnea.
DISE is a standard method in diagnosis of OSAS and its specific localisation and severity. 20 patients with polysomnographic diagnosed OSAS will be enrolled in this prospective observational study. All patients would get a DISE because of the before mentioned reasons (localisation and severity) although they wouldn't participate in this study. They will get a 24-h-RR (blood pressure)-measurement, a transthoracic echocardiography, a peak-flow-test and routine lab examination including troponin and proBNP before the examination. Furthermore they have to fill out the Epworth Sleepiness Scale questionaire.
Before starting the DISE a standard-monitoring (Electrocardiography, pulse oximetry, non-invasive blood pressure, patient state index, near infrared spectroscopy, transcutaneous CO2 (carbon dioxide), invasive blood pressure) will be established. After applying the monitoring the DISE is started by target controlled infusion (Marsh Model) with a sighted goal-concentration of 3.0 µg/ml Propofol in 5 minutes. While the examination a stabile snoring-phase with apnoea/hypopnoea is needed. In this moment a video-endoscopy is started to quantify the level of obstruction. After DISE the sedation will end and the patients will be transported to the recovery room or postanesthesia care unit (PACU). For specific order of events a video recording of the DISE will be realized.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| DISE group | All patients in this study group will receive a propofol PSI controlled DISE (drug induced sleep endoscopy). |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PSI | Device | The PSI delivered by Masimo Root (Sedline) will be measured in all patients. |
|
| Measure | Description | Time Frame |
|---|---|---|
| PSI | Depth of sedation is monitored with a SEDline electroencephalograph based monitor that displays patient state index (PSI). | Duration of surgery (an average of 2 hours) |
| Measure | Description | Time Frame |
|---|---|---|
| NIRS (near-infrared spectrometry) | Near-infrared spectrometry in % of left and right hemisphere | Duration of surgery (an average of 2 hours) |
| transcutaneous CO2 (carbon dioxide) | Measured at the chest. |
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Inclusion Criteria:
Exclusion Criteria:
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18 years or older voluntary patients with an obstructive sleep apnea syndrome undergoing elective propofol induced sleep endoscopy at Charité - Universitätsmedizin Berlin Campus Charite Mitte.
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| Name | Affiliation | Role |
|---|---|---|
| Sascha Treskatsch, MD, Prof | Charite University, Berlin, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Charité - Universitätsmedizin Berlin Campus Charité Mitte | Berlin | State of Berlin | 10115 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
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| Duration of surgery (an average of 2 hours) |
| transcutaneous O2 (oxygen) | Measured at the center of the chest. | Duration of surgery (an average of 2 hours) |
| Propofol | Total amount of administered propofol. | Duration of surgery (an average of 2 hours) |
| Diaphragma movement | Diaphragma movement is measured by ultrasound. | Duration of surgery (an average of 2 hours) |
| blood gases | Arterial blood gas is obtained from an arterial line. | Duration of surgery (an average of 2 hours) |
| heart rate | by ECG. | Duration of surgery (an average of 2 hours) |
| blood pressure | NIBP and IBP. | Duration of surgery (an average of 2 hours) |
| TTE (transthoracic echocardiography) | Parameters of left and right ventricular function, as well as function of heart valves before DISE. | shortly before DISE (an average of 30 minutes) |
| EEG parameters | Parameters measured by the Sedline monitor | Duration of surgery (an average of 2 hours) |
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| ID | Term |
|---|---|
| D020181 | Sleep Apnea, Obstructive |
| ID | Term |
|---|---|
| D012891 | Sleep Apnea Syndromes |
| D001049 | Apnea |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
| D020919 | Sleep Disorders, Intrinsic |
| D020920 | Dyssomnias |
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
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