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The application of nasal and oronasal cannulas in the detection of respiratory disturbances during sleep: A review

Die Anwendung nasaler und oronasaler Kanülen zum Nachweis schlafbezogener Atmungsstörungen: Eine Literaturübersicht

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Summary

Question of the Study

This review focuses on nasal/oronasal cannulas (NOCs) used as flow sensors and their advantages and disadvantages especially in comparison with oronasal thermistors for diagnostics in sleep medicine. The significance of NOCs in the detection of the upper airway resistance syndrome (UARS) is discussed in comparison with other methods of measurement.

Methods

Flow measurement by NOCs is a pressure measurement of dammed-up air that results from an artificial resistance (the respective cannula) in the airway openings. This pressure signal is characterized by a precise time resolution and allows quantification of the airflow after calibration.

Results

The most important studies on NOCs are summarized. The main emphasis is on comparative methodological investigations, e.g. thermistor versus NOC or NOC versus oesophageal manometry.

Conclusions

The results of different studies as well as our own investigations show that inspiratory flattenings of the NOC signal are observed especially when UARS is validated by oesophageal manometry. Intrathoracic pressure fluctuations correspond well with inspiratory and expiratory flow limitations. In contrast to the thermistor signal, the recordings from the NOC can be quantified after calibration of the system, thus eliminating the dis-advantages of the oesophageal manometry (invasive) and the thermistor (insufficient time resolution) without loss of information.

Zusammenfassung

Fragestellung

Im vorliegenden Übersichtsreferat zur Anwendung nasaler/oronasaler Kanülen (NOC) als Atemflusssensor wird die Frage erörtert, welche Vor- und Nachteile NOC im Vergleich zum Thermistor in der schlafmedizinischen Diagnostik haben. Die Bedeutung von NOC beim Nachweis des upper airway resistance syndrome (UARS) wird im Vergleiche mit weiteren Messmethoden diskutier.

Methodik

Die Atemflussmessung mittels NOC stellt eine Druckmessung des Luftstaus dar, der sich durch einen in die Atemwegsöffnungen eingebrachten Widerstand (in Form einer Kanüle) ergibt. Das erhaltene Signal weist eine exakte Zeitauflösung auf und ermöglicht nach Kalibrierung eine Quantifizierung des Atemflusses.

Ergebnisse

Die Inhalte der wichtigsten Publikationen zum Thema werden zusammengefasst. Schwerpunkt bilden Arbeiten zum direkten Methodenvergleich, wie z. B. Thermistor versus NOC oder NOC versus Oesophaguskatheter.

Schlussfolgerungen

Die Ergebnisse verschiedener Studien sowie unsere eigenen Untersuchungen zeigen, dass insbesondere inspiratorische Abflachungen des NOC-Signals (Plateaubildung) mit dem per Oesophaguskatheter detektierten UARS übereinstimmen. Intrathorakale Druckschwankungen korrespondieren mit in- und exspiratorischen Flusslimitationen. Im Gegensatz zum Thermistorsignal eignet sich das Signal einer NOC darüber hinaus zur Quantifizierung des Atemflusses, wodurch sich die Nachteile von Oesophaguskatheter (Invasivität) und Thermistor (mangelnde Zeitauflösung) ohne wesentlichen Informationsverlust eliminieren Iassen.

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Authors and Affiliations

  1. Fachkrankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs-und Schlafmedizin, Annostr. 1, D-57392, Schmallenberg, Germany

    Jens Kerl, Dieter Köhler & Bernd Schönhofer

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  1. Jens Kerl
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  2. Dieter Köhler
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  3. Bernd Schönhofer
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Correspondence to Jens Kerl.

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Kerl, J., Köhler, D. & Schönhofer, B. The application of nasal and oronasal cannulas in the detection of respiratory disturbances during sleep: A review. Somnologie 6, 169–172 (2002). https://doi.org/10.1046/j.1439-054X.2002.02186.x

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  • DOI: https://doi.org/10.1046/j.1439-054X.2002.02186.x

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