Ability of single anesthesia for combined robotic-assisted bronchoscopy and surgical lobectomy to reduce time between detection and treatment in stage I non-small cell lung cancer.

Background: Early identification, diagnosis, and treatment of lung cancer is associated with improved clinical outcomes. Robotic-assisted bronchoscopy improves the ability to diagnose early stage lung malignancies and, when combined with robotic-assisted lobectomy under single anesthesia, could reduce time from identification to intervention in early stage lung cancer in a select patient population.

Methods: A retrospective case-control single-center study compared patients with radiographic stage I non-small cell carcinoma (NSCCA) undergoing robotic navigational bronchoscopy and surgical resection (N = 22) with historical controls (N = 63).

Systolic pressure response to voluntary apnea predicts sympathetic tone in obstructive sleep apnea as a clinically useful index.

The present investigation tested the hypotheses that systolic arterial pressure (SAP) responses to voluntary apnea (a) serve as a surrogate of sympathetic nerve activity (SNA), (b) can distinguish Obstructive Sleep Apnea (OSA) patients from control subjects and (c) can document autonomic effects of treatment. 9 OSA and 10 control subjects were recruited in a laboratory study; 44 OSA subjects and 78 control subjects were recruited in a clinical study; and 21 untreated OSA subjects and 14 well-treated OSA subjects were recruited into a treatment study. Each subject performed hypoxic and room air voluntary apneas in triplicate.

Sleep disordered breathing detection using heart rate variability and R-peak envelope spectrogram.

We report that combining the interbeat heart rate as measured by the RR interval (RR) and R-peak envelope (RPE) derived from R-peak of ECG waveform may significantly improve the detection of sleep disordered breathing (SDB) from single lead ECG recording. The method uses textural features extracted from normalized gray-level cooccurrence matrices of the time frequency plots of HRV or RPE sequences. An optimum subset of textural features is selected for classification of the records.

Cross correlation and scatter plots of the heart rate variability and R-peak Envelope as features in the detection of obstructive sleep apnea.

Interbeat heart rate as measured by the RR interval (RR) and R-Peak Envelope (RPE) are two signals that can be extracted from an Electrocardiogram (ECG) with relative ease and high reliability. RR and RPE have been shown to carry markers for detecting sleep disordered breathing (SDB). In this pilot study, we explore the cross correlation of RR and RPE in normal and SDB patients.

A new method to detect obstructive sleep apnea using fuzzy classification of time-frequency plots of the heart rate variability.

This paper presents a new method of analyzing time frequency plots of heart rate variability to detect sleep disordered breathing from nocturnal ECG. Data is collected from 12 normal subjects (7 males, 5 females; age 46 +/- 9.38 years, AHI 3.

A method to detect obstructive sleep apnea using neural network classification of time-frequency plots of the heart rate variability.

This paper presents a new method of analyzing time-frequency plots of heart rate variability to detect sleep disordered breathing from nocturnal ECG. Data is collected from 12 normal subjects (7 males, 5 females; age 46+/-9.38 years, AHI 3.

Detecting electroencephalography variations due to sleep disordered breathing events.

This study investigates the ability of EEG in identifying apnea/hypopnea events. A preliminary study was performed on 13 subjects (ages: 49.08+/-8.

ECG biomarkers for simultaneous detection of obstructive sleep apnea and Cheyne-Stokes breathing.

Use of extended electrocardiography (ECG) for detection of sleep disordered breathing SDB when obstructive sleep apneas and Cheyne-Stokes breathing are simultaneously present is explored. A multi-tier algorithm is designed that uses quantitative changes in the morphology of the QRS complex of Lead 1 and V4 due of SDB events and combines those changes with variations in heart rate to detect each type of SDB. For this purpose, ECG signals are divided into 15 minute epochs.

Classification of Cheyne-Stokes breathing and obstructive sleep apnea using ECG.

High cost of diagnostic studies to detect sleep disordered breathing and lack of availability of certified sleep laboratories in all inhabited areas make investigation of alternative methods of detecting sleep disordered breathing attractive. This study aimed to explore the possibility of discerning obstructive sleep apnea (OSA) from Cheyne-Stokes respiration (CSR) using overnight electrocardiography (ECG). Polysomnographic and ECG signals were acquired from the 13 OSA and 7 CSR volunteer subjects.

Time domain analysis of R-wave attenuation envelope for sleep apnea detection.

Time domain analysis was carried out on the R-wave attenuation (RWA) envelope of the subjects with and without obstructive sleep apnea. The RWA envelope is derived from the morphology of the electrocardiogram (ECG) obtained during polysomnography data collection of the subjects. Nocturnal polysomnography was performed on 16 normal subjects and 14 obstructive sleep apnea (OSA) patients.

Periods of intermittent hypoxic apnea can alter chemoreflex control of sympathetic nerve activity in humans.

Obstructive sleep apnea is associated with sustained elevation of muscle sympathetic nerve activity (MSNA) and altered chemoreflex control of MSNA, both of which likely play an important role in the development of hypertension in these patients. Additionally, short-term exposure to intermittent hypoxic apneas can produce a sustained elevation of MSNA. Therefore, we tested the hypothesis that 20 min of intermittent hypoxic apneas can alter chemoreflex control of MSNA.