Tracheostomy and Hemodynamic Changes in Sleep-Induced Apnea

Abstract

Because pulmonary hypertension and systemic hypertension occur during sleep-induced obstructive apnea, six patients underwent overnight hemodynamic monitoring before and after tracheostomy. Variables studied included heart rate, pulmonary artery pressure, femoral artery pressure, and arterial oxygen tension (PO₂). After tracheostomy, significant reductions were noted during sleep in mean pulmonary artery pressure from 45 ± 6 mm Hg (mean ± SEM)to 22 ± 2 mm Hg (P < 0.05) and in mean femoral artery pressure from 137 ± 6 mm Hg to 97 ± 3 mm Hg (P < 0.005). There was also a significant increase for the group in arterial PO₂ recorded during the apneic episodes from 38 ± 3 mm Hg before tracheostomy to 71 ± 2 mm Hg (P < 0.001) after tracheostomy. We conclude that tracheostomy improves the hemodynamic abnormalities and hypoxemia that occur during sleep in patients with sleep-induced obstructive apnea.