Adaptive Pressure Support Servo-Ventilation
- 15 August 2001
- journal article
- clinical trial
- Published by American Thoracic Society in American Journal of Respiratory and Critical Care Medicine
- Vol. 164 (4), 614-619
- https://doi.org/10.1164/ajrccm.164.4.9908114
Abstract
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 H2O), bilevel (mean 13.5/5.2 cm H2O), or ASV largely at the default settings (mean pressure 7 to 9 cm H2O) 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. Keywords: Cheyne-Stokes respiration; heart failure; oxygen; CPAP; bilevel ventilation; adaptive servo-ventilation; sleepKeywords
This publication has 24 references indexed in Scilit:
- Prognostic Value of Nocturnal Cheyne-Stokes Respiration in Chronic Heart FailureCirculation, 1999
- Treatment of Cheyne-Stokes respiration with nasal oxygen and carbon dioxideEuropean Respiratory Journal, 1998
- Sleep Apnea in 81 Ambulatory Male Patients With Stable Heart FailureCirculation, 1998
- Effect of oxygen on sleep quality, cognitive function and sympathetic activity in patients with chronic heart failure and Cheyne-Stokes respiration.Published by Oxford University Press (OUP) ,1998
- Reversal of Central Sleep Apnea With OxygenChest, 1997
- Improvement of exercise capacity with treatment of Cheyne-Stokes respiration in patients with congestive heart failureJournal of the American College of Cardiology, 1996
- Increased mortality associated with Cheyne-Stokes respiration in patients with congestive heart failure.American Journal of Respiratory and Critical Care Medicine, 1996
- Occult Sleep-Disordered Breathing in Stable Congestive Heart FailureAnnals of Internal Medicine, 1995
- Treatment of congestive heart failure and Cheyne-Stokes respiration during sleep by continuous positive airway pressure.American Journal of Respiratory and Critical Care Medicine, 1995
- Respiration and Abnormal Sleep in Patients with Congestive Heart FailureChest, 1989