Document Detail


Adaptive pressure support servo-ventilation: a novel treatment for Cheyne-Stokes respiration in heart failure.
MedLine Citation:
PMID:  11520725     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Adaptive servo-ventilation (ASV) is a novel method of ventilatory support designed for Cheyne-Stokes respiration (CSR) in heart failure. The aim of our study was to compare the effect of one night of ASV on sleep and breathing with the effect of other treatments. Fourteen subjects with stable cardiac failure and receiving optimal medical treatment were tested untreated and on four treatment nights in random order: nasal oxygen (2 L/min), continuous positive airway pressure (CPAP) (mean 9.25 cm H(2)O), bilevel (mean 13.5/5.2 cm H(2)O), or ASV largely at the default settings (mean pressure 7 to 9 cm H(2)O) during polysomnography. Thermistor apnea + hypopnea index (AHI) declined from 44.5 +/- 3.4/h (SEM) untreated to 28.2 +/- 3.4/h oxygen and 26.8 +/- 4.6/h CPAP (both p < 0.001 versus control), 14.8 +/- 2.3/h bilevel, and 6.3 +/- 0.9/h ASV (p < 0.001 versus bilevel). Effort band AHI behaved similarly. Arousal index decreased from 65.1 +/- 3.9/h untreated to 29.8 +/- 2.8/h oxygen and 29.9 +/- 3.2/h CPAP, to 16.0 +/- 1.3/h bilevel and 14.7 +/- 1.8/h ASV (p < 0.01 versus all except bilevel). There were large increases in slow-wave and rapid eye movement (REM) sleep with ASV but not with oxygen or CPAP. All subjects preferred ASV to CPAP. One night ASV suppresses central sleep apnea and/or CSR (CSA/CSR) in heart failure and improves sleep quality better than CPAP or 2 L/min oxygen.
Authors:
H Teschler; J Döhring; Y M Wang; M Berthon-Jones
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  164     ISSN:  1073-449X     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-08-24     Completed Date:  2001-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  614-9     Citation Subset:  AIM; IM    
Affiliation:
Faculty of Medicine, Ruhrlandklinik, University of Essen, Essen, Germany. Helmutt@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Arousal
Blood Gas Analysis
Cheyne-Stokes Respiration / diagnosis,  etiology*,  metabolism,  physiopathology,  therapy*
Cross-Over Studies
Forced Expiratory Volume
Heart Failure / complications*
Humans
Middle Aged
Oxygen Inhalation Therapy / standards
Polysomnography
Positive-Pressure Respiration / instrumentation,  methods*,  standards
Prospective Studies
Severity of Illness Index
Sleep, REM
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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