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Core Curriculum in Emergency Medicine integrated in the Specialty of Anaesthesiology |
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European Board of Anaesthesiology
Anaesthesiology is a medical specialty, which has developed from a specialty with responsabilities for anaesthesia for surgical procedures to a specialty with expertise in pre- per- and postanaesthesia care and as a consequence of the knowledge and skills in that field with expertise in a broader scale in emergency medicine, intensive care medicine and pain medicine. Sharing and communicating the ensuing responsibilities with other medical and surgical specialties has resulted in considerable improvement of quality of medical care.
The postoperative period, critical care and pre and in-hospital management of emergency situations have such great similarities to the work in the operating room that anaesthesiological expertise in these areas has been recognized in many countries as integral parts of the specialty of anaesthesiology.  Propozitions of UEMS
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Nocturnal pulse oximetry studies in patients with COPD |
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For more than 40 years, it has been understood that sleep can accentuate hypoxemia in patients with COPD [1]. The earliest nocturnal polygraph studies of patients were in 1975, and include intermittent blood gas tension measurements during sleep [2]. However, it was only with the advent of reliable pulse oximeters in 1976 that the respiratory "events" occurring during sleep could be clearly defined. After the landmark study by Flick and Block in 1977 [3], several groups went on to show that patients with COPD experienced a worsening of hypoxemia particularly during REM sleep [4,5,6].
The initial studies focused almost entirely on patients having severe disease, and who were clearly hypoxemic during the day. Publications studying nocturnal hypoxemia in patients with little or no daytime hypoxemia (i.e. arterial oxygen tension, PaO2 > 60mmHg) appeared only later [7,8,9].
In this short review, we will present the characteristics of nocturnal hypoxemia in COPD patients, its mechanisms and consequences, and we will consider the treatment options currently available. Finally, practical issues about pulse oximetry during nocturnal studies will be exposed.  Nocturnal pulse oximetry
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Skola za Anestezija
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