| Continuous positive airway pressure: new generations. | |
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MedLine Citation:
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PMID: 12800787 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Automatic positive airway pressure devices are the most technologically advanced positive airway pressure devices available for use in OSA. Although heterogeneous, they have in common the ability to detect and respond to changes in upper airway resistance. Data cannot necessarily be extrapolated from one device to another, and the field is rapidly advancing. Most studies of APAP have been performed in a supervised setting, or patients have been carefully selected to have a high likelihood of OSA uncomplicated by disorders such as alveolar hypoventilation or central apnea or technical problems such as mask leaks. Studies of APAP for the diagnosis of OSA have shown that APAP can diagnose severe OSA effectively, but the diagnosis of mild-moderate OSA is less reliable. APAP devices also can be effective therapy for selected patients with OSA, with overall similar results to conventional fixed CPAP in terms of respiratory disturbances, sleep quality, nocturnal oxygenation, and daytime sleepiness and performance, with less known or other long-term outcomes. In most studies, mean treatment pressures are lower, without change in side effect profile. Compliance and preference with APAP are similar to or somewhat better than CPAP in most studies. APAP also can be used in an attended setting to titrate an effective pressure for use in long-term conventional CPAP therapy, also with similar results to CPAP in many patients. APAP devices are more expensive than CPAP devices, but the cost may be outweighed if a group of patients who can be diagnosed, treated, or titrated safely in the unattended setting can be identified. Although diagnostic and therapeutic algorithms for APAP have been proposed, the best candidates for this modality must be defined better. |
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Authors:
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Francoise J Roux; Janet Hilbert |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Clinics in chest medicine Volume: 24 ISSN: 0272-5231 ISO Abbreviation: Clin. Chest Med. Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-12 Completed Date: 2003-07-02 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7907612 Medline TA: Clin Chest Med Country: United States |
Other Details:
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Languages: eng Pagination: 315-42 Citation Subset: IM |
Affiliation:
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Section of Pulmonary and Critical Care Medicine, Yale University School of Medicine, 333 Cedar Street, Post Office Box 208057, New Haven, CT 06520-8057, USA. francoise.roux@yale.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Airway Resistance
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physiology Clinical Trials as Topic Equipment Design Humans Polysomnography Positive-Pressure Respiration / instrumentation*, methods Respiratory Physiological Phenomena Sleep Apnea, Obstructive / therapy* |
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