<p>Cher Confr&egrave;re</p>
<p>J'ai vu ce jour M. FENELON Charlemagne n&eacute; le 18/07/1937.</p>
<p>Sa polysomnographie du 21/01/2014 n'a malheureusement port&eacute;e que sur une p&eacute;riode de 1H30.</p>
<p>Elle a a montr&eacute; 2 micro&eacute;veils/H avec un IAH(Index d'apn&eacute;es hypopn&eacute;es) &agrave; 6/H. Cet index passe &agrave; 10/H quand on y associe les diminutions de d&eacute;bit.</p>
<p>Par ailleurs on retrouve 3 d&eacute;saturations/H avec une SaO2 minimale de 85%.La SaO2 moyenne est &agrave; 86%.M.Fenelon pr&eacute;sente 12 mouvements p&eacute;riodiques des jambes /H pendant son sommeil.</p>
<p>M.Fenelon refuse de toute fa&ccedil;on un appareillage en dehors de l'OLD(oxyg&eacute;noth&eacute;rapie de longue dur&eacute;e).</p>
<p>Ses EFR retrouvent ce jour:un trouble ventilatoire obstructif GOLD IV &nbsp;tr&egrave;s s&eacute;v&egrave;re avec un VEMS &agrave; 0.66 soit 23% et un rapport de Tiffeneau &agrave; 51% de la norme.Il existe des troubles de la diffusion avec TLCO &agrave; 50% de la norme.</p>
<p>Il convient de poursuivre chez lui: ONBREZ 300 1B/j,Spiriva Respimat 2B/j OLD; &nbsp; A&eacute;rosolth&eacute;rapie(Bricanyl-Atrovent)X2/j + PULMICORTX2 &nbsp;et Kin&eacute;siettt respiratoire .Vaccination antigrippale annuelle et Pneumo 23 tous les 5 ans. &nbsp;</p>
<p>Avec mes remerciements, veuillez agr&eacute;er, cher Confr&egrave;re, l'assurance des mes sentiments distingu&eacute;s,</p>
<p>Dr. B. TANGUY.</p>
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