ELOISA MARIA MELLO SANTIAGO GEBRIM

(Fonte: Lattes)
Índice h a partir de 2011
14
Lattes
Projetos de Pesquisa
Unidades Organizacionais
Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina - Médico

Filtros

Limpar filtros

Configurações

Colaboração internacional: Itália × Assunto: obstructive sleep-apnea ×

Resultados de Busca

Agora exibindo 1 - 2 de 2
  • article 3 Citação(ões) na Scopus
    Influence of interface and position on upper airway collapsibility assessed by negative expiratory pressure
    (2017) HIRATA, Raquel Pastrello; KAYAMORI, Fabiane; SCHORR, Fabiola; MORIYA, Henrique Takachi; ROMANO, Salvatore; INSALACO, Giuseppe; GEBRIM, Eloisa; OLIVEIRA, Luis Vicente Franco de; GENTA, Pedro Rodrigues; LORENZI-FILHO, Geraldo
    Purpose Negative expiratory pressure (NEP) is a simple technique for the evaluation of upper airway collapsibility in patients with obstructive sleep apnea (OSA). Most studies evaluated NEP using a mouthpiece that may exclude the cephalic portion of the upper airway. We hypothesize that NEP determination is influenced by interface and position. Methods We evaluated patients with suspected OSA using polysomnography, NEP (-5 cmH(2)O in sitting and supine position with mouthpiece and nasal mask). A subgroup also underwent computed tomography (CT) of the upper airway. Results We studied a total of 86 subjects (72 male, age 46 +/- 12 yrs, body mass index 30.0 +/- 4.4 kg/m(2), neck circumference 40.0 +/- 3.5 cm, AHI 32.9 +/- 26.4, range 0.5 to 122.5 events/hour). NEP was influenced by interface and position (p = 0.007), and upper airwaywas more collapsible with mouthpiece than with nasal mask in sitting position (p = 0.001). Position influenced NEP and was worse in supine only when evaluated by nasal mask. Expiratory resistance (R-0.2) at 0.2 s during NEP was significantly higher and independent of position with mouthpiece than with nasal mask (20.7 versus 8.6 cmH(2)O/L s(-1), respectively, p = 0.018). NEP evaluated with nasal mask in supine position and with mouthpiece in sitting position, but not when evaluated with mouthpiece in supine position, were correlated with upper airway anatomical measurements including tongue dimensions and pharyngeal length. Conclusions Interface and position influence NEP. NEP evaluated with nasal mask in supine position may convey more relevant information for patients under investigation for OSA than when evaluated with mouthpiece.
  • article 32 Citação(ões) na Scopus
    Upper Airway Collapsibility Assessed by Negative Expiratory Pressure while Awake is Associated with Upper Airway Anatomy
    (2016) HIRATA, Raquel P.; SCHORR, Fabiola; KAYAMORI, Fabiane; MORIYA, Henrique Takachi; ROMANO, Salvatore; INSALACO, Giuseppe; GEBRIM, Eloisa M.; OLIVEIRA, Luis Vicente Franco de; GENTA, Pedro R.; LORENZI-FILHO, Geraldo
    Study Objectives: There is a growing interest to develop a simple method to characterize the mechanisms leading to upper airway collapse in order to guide treatment options in patients with obstructive sleep apnea (OSA). Critical closing pressure (Pcrit) during sleep is able to predict the anatomical component of OSA. However, Pcrit is a laborious method that is only used for research purposes. The application of negative expiratory pressure (NEP) is a simple method to assess upper airway collapsibility that can be easily performed during wakefulness. We hypothesized that NEP will be, similarly to Pcrit, associated with upper airway anatomy assessed by computed tomography (CT) scan. Methods: Patients under investigation for OSA underwent polysomnography, CT of the upper airway, NEP while awake, and Pcrit during sleep. NEP was performed with -5 cm H2O in supine position using a nasal mask. Pcrit was measured during sleep induced by low doses of midazolam. Results: Twenty-eight male subjects were studied (age 45 +/- 13 y, body mass index 29.4 +/- 4.9 kg/m(2), apnea-hypopnea index (AHI) 30 +/- 26, range 2 to 86 events/ h). NEP and Pcrit were similarly associated with tongue area (r = 0.646 and r = 0.585), tongue volume (r = 0.565 and r = 0.613) and pharyngeal length (r = 0.580 and r = 0.611), respectively (p < 0.05 for all comparisons). NEP and Pcrit were also significantly correlated with AHI (r = 0.490 and r = 0.531). NEP and Pcrit were significantly higher in patients with severe OSA than the remaining population. Conclusions: NEP is a simple and promising method that is associated with the anatomical component of upper airway collapsibility. NEP may be valuable to select patients for noncontinuous positive airway pressure alternative therapies for OSA.