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Positive airway pressure

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https://www.readbyqxmd.com/read/28534455/effect-of-modern-surgical-treatment-on-the-inflammatory-anti-inflammatory-balance-in-patients-with-obstructive-sleep-apnoea
#1
M Binar, T M Akcam, O Karakoc, R I Sagkan, U Musabak, M Gerek
OBJECTIVE: To investigate the inflammatory/anti-inflammatory cytokine balance - T helper 1/T helper 2 ratios - in obstructive sleep apnoea patients, before and after treatment. METHODS: Twenty-eight patients received continuous positive airway pressure treatment and 29 patients who could not tolerate continuous positive airway pressure were scheduled for surgery. Serum levels of interleukins 2, 4 and 10, tumour necrosis factor-alpha, and interferon gamma were analysed by enzyme-linked immunosorbent assays before and three months after treatment...
May 23, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28532519/a-case-of-severe-obstructive-sleep-apnoea-in-madelung-s-disease-treated-by-lateral-pharyngoplasty
#2
V Pinto, P G Morselli, D Tassone, O Piccin
BACKGROUND: Madelung's disease is a rare disorder characterised by the presence of multiple, symmetric, non-capsulated fat masses in the face, neck and other areas of upper extremities. In some cases, severe clinical complications such as upper airway compression can occur. CASE REPORT: A 56-year-old man affected by Madelung's disease complained of snoring and severe daytime sleepiness. Polysomnography revealed severe obstructive sleep apnoea. An attempt to treat sleep apnoea by continuous positive airway pressure failed because of poor compliance...
May 23, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#3
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28530153/baseline-sleep-efficiency-and-arousal-index-do-not-predict-who-will-benefit-from-sedatives-in-improving-positive-airway-pressure-adherence-in-sleep-apnea-to-90
#4
R Bart Sangal
Positive airway pressure (PAP) is the preferred treatment for obstructive sleep apnea (OSA), but adherence is low. Educational or ongoing supportive intervention improves the number of PAP adherent patients from the 50% to the 70% range. A common side effect of PAP is increased awakenings. This prospective trial examined baseline polysomnographically derived sleep efficiency and arousal index in PAP adherent and nonadherent patients, and in patients needing sedating medicines to attain PAP adherence versus those who did not need such medicines...
May 1, 2017: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/28530140/associations-of-nasopharyngeal-metabolome-and-microbiome-with-severity-among-infants-with-bronchiolitis-a-multi-omic-analysis
#5
Christopher J Stewart, Jonathan M Mansbach, Matthew C Wong, Nadim J Ajami, Joseph F Petrosino, Carlos A Camargo, Kohei Hasegawa
RATIONALE: Bronchiolitis is the most common lower respiratory infection in infants; however, it remains unclear which infants with bronchiolitis will develop severe illness. In addition, while emerging evidence indicates associations of the upper-airway microbiome with bronchiolitis severity, little is known about the mechanisms linking airway microbes and host response to disease severity. OBJECTIVES: To determine the relations among the nasopharyngeal airway metabolome profiles, microbiome profiles, and severity in infants with bronchiolitis...
May 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#6
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28527878/obstructive-sleep-apnea-and-diabetes-a-state-of-the-art-review
#7
REVIEW
Sirimon Reutrakul, Babak Mokhlesi
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28526465/-selective-lobar-blockade-with-a-coopdech-blocker-combined-with-a-double-lumen-endotracheal-tube-for-lung-metastases-resection-by-laser
#8
Patricia Cruz, Hugo David Orozco, Ignacio Garutti Martinez, Gloria Hernández Fernández
In recent years, laser resection of lung metastases has been established as the standard procedure worldwide. To avoid airway fire, it is necessary to collapse the surgical lung. The selective lobar bronchial blockade is a technique that allows one-lung ventilation while the operated lobe is collapsed in patients with previous pulmonary resection requiring subsequent resection or with limited pulmonary reserve. We report a clinical case about our experience of a selective lobar bronchial blockade technique with a bronchial blocker (Coopdech endobronchial blocker) that was employed successfully with a double-lumen endotracheal tube in a patient with previous contralateral pulmonary resection who was scheduled for atypical resections of pulmonary metastases by laser...
May 16, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28522758/regulation-of-erythropoiesis-after-normoxic-return-from-chronic-sustained-and-intermittent-hypoxia
#9
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28522275/impact-of-continuous-positive-airway-pressure-on-left-ventricular-systolic-loading-and-coronary-flow-reserve-in-healthy-young-men
#10
Volker Schulze, Christian Meyer, Christian Eickholt, Roberto Sansone, Stefanie Keymel, Christian Heiss, Tienush Rassaf, Malte Kelm, Stephan Steiner
BACKGROUND: Increased augmentation index (AIx) is accompanied by an elevated cardiovascular risk. A reduction of AIx is known for long-term continuous positive airway pressure (CPAP) therapy. We hypothesised that acute preload and left ventricular workload effects AIx and subendocardial viability ratio (SEVR) as a marker of coronary flow reserve. METHODS: Increased augmentation index and central blood pressure parameters were measured by radial artery tonometry in 17 healthy men (32/±6years) at rest and during CPAP ventilation at pressures of 5, 10mbar and after recovery...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28522094/continuous-positive-air-pressure-improves-orthonasal-olfactory-function-of-patients-with-obstructive-sleep-apnea
#11
Ute Walliczek-Dworschak, Werner Cassel, Luisa Mittendorf, Robert Pellegrino, Ulrich Koehler, Christian Güldner, Philipp Otto Georg Dworschak, Olaf Hildebrandt, Hanna Daniel, Thomas Günzel, Afshin Teymoortash, Thomas Hummel
OBJECTIVE: Recent studies have suggested that patients with obstructive sleep apnea (OSA) might be affected by olfactory impairment. However, more evidence is needed on the effect that OSA has on the chemical senses (olfaction and gustatory) of these patients, and whether continuous positive airway pressure (CPAP) treatment might help to reverse possible impairment. METHODS: A prospective study was conducted with 44 OSA patients (17 female and 27 male, mean age 54 ± 9...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28522081/natural-course-and-potential-prognostic-factors-for-sleep-disordered-breathing-in-multiple-system-atrophy
#12
Yasuyoshi Ohshima, Hideaki Nakayama, Naho Matsuyama, Satoshi Hokari, Takuro Sakagami, Tomoe Sato, Toshiyuki Koya, Tetsuya Takahashi, Toshiaki Kikuchi, Masatoyo Nishizawa, Takayoshi Shimohata
OBJECTIVE/BACKGROUND: Multiple system atrophy (MSA) frequently results in the development of sleep-disordered breathing (SDB). Few reports have described the natural course of this phenomenon. The aim of the present study was to determine the natural course of SDB and prognostic factors associated with such conditions in MSA. PATIENTS/METHODS: Twenty-four consecutive patients were recruited with probable MSA, who had not been treated with continuous positive airway pressure (CPAP) and had undergone overnight polysomnography (PSG) more than once following the development of snoring or stridor...
June 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28520763/genome-wide-gene-expression-array-identifies-novel-genes-related-to-disease-severity-and-excessive-daytime-sleepiness-in-patients-with-obstructive-sleep-apnea
#13
Yung-Che Chen, Kuang-Den Chen, Mao-Chang Su, Chien-Hung Chin, Chung-Jen Chen, Chia-Wei Liou, Ting-Wen Chen, Ya-Chun Chang, Kuo-Tung Huang, Chin-Chou Wang, Ting-Ya Wang, Jen-Chieh Chang, Yong-Yong Lin, Yi-Xin Zheng, Meng-Chih Lin, Chang-Chun Hsiao
We aimed to identify novel molecular associations between chronic intermittent hypoxia with re-oxygenation and adverse consequences in obstructive sleep apnea (OSA). We analyzed gene expression profiles of peripheral blood mononuclear cells from 48 patients with sleep-disordered breathing stratified into four groups: primary snoring (PS), moderate to severe OSA (MSO), very severe OSA (VSO), and very severe OSA patients on long-term continuous positive airway pressure treatment (VSOC). Comparisons of the microarray gene expression data identified eight genes up-regulated with OSA and down-regulated with CPAP treatment, and five genes down-regulated with OSA and up-regulated with CPAP treatment...
2017: PloS One
https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#14
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28516964/barbed-reposition-pharyngoplasty-in-multilevel-robotic-surgery-for-obstructive-sleep-apnoea
#15
C Vicini, G Meccariello, G Cammaroto, M Rashwan, F Montevecchi
The surgical treatment of obstructive sleep apnoea in patients who are non-compliant with continuous positive airway pressure therapy still represents a valid alternative. In recent years, the multilevel approach is becoming more diffuse in routine surgical practice, especially since the introduction of transoral robotic surgery. Barbed reposition pharyngoplasty in multilevel robotic surgery for OSA may represent a valid option to surgically approach the soft palate. Herein, we describe the technique and preliminary results of our experience...
June 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28513068/a-randomized-controlled-trial-branched-chain-amino-acid-levels-and-glucose-metabolism-in-patients-with-obesity-and-sleep-apnea
#16
Antonia Barceló, Daniel Morell-Garcia, Neus Salord, Cristina Esquinas, Gerardo Pérez, Antonio Pérez, Carmen Monasterio, Merce Gasa, Ana Maria Fortuna, Josep Maria Montserrat, Mercedes Mayos
There is evidence that changes in branched-chain amino acid (BCAA) levels may correlate with the efficacy of therapeutic interventions for affecting improvement in metabolic control. The objective of this study was to evaluate whether serum concentrations of BCAAs (leucine, isoleucine, valine) could mediate in insulin sensitivity and glucose tolerance after continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). A prospective randomized controlled trial of OSA patients with morbid obesity was conducted...
May 17, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28507580/impact-of-antenatal-oxytocin-infusion-on-neonatal-respiratory-morbidity-associated-with-elective-cesarean-section
#17
Ibrahim Abdelazim, Mohamed M M Farghali, Assem A M Elbiaa, Khaled M Abdelrazak, Mohamed Hussain, Amr H Yehia, Mona Rashad
INTRODUCTION: This study was designed to estimate respiratory morbidity associated with elective cesarean section (ECS) and to determine the effect of antenatal oxytocin exposure on this morbidity. MATERIAL AND METHODS: Nine hundred and sixty-five neonates ≥ 37 weeks' gestation delivered by cesarean section during 1 year were included in this retrospective study and classified into two groups according to oxytocin exposure before cesarean deliveries. Respiratory morbidity for each group was recorded and statistically analyzed...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28506358/-research-advances-in-noninvasive-high-frequency-oscillatory-ventilation-in-neonates
#18
Jia Huang, Lin Yuan, Chao Chen
Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28506075/cardiovascular-effects-of-continuous-positive-airway-pressure-treatment-in-patients-with-obstructive-sleep-apnea-a-meta-analysis
#19
Gamze Aslan, Baris Afsar, Dimitrie Siriopol, Asiye Kanbay, Oguzhan Sal, Caghan Benli, John Okcuoglu, Adrian Covic, Mehmet Kanbay
Continuous positive airway pressure (CPAP) is the first-line treatment of obstructive sleep apnea (OSA). Obstructive sleep apnea is a predictor of cardiovascular (CV) events. In this meta-analysis, we evaluated the effect of CPAP on left ventricular ejection fraction (LVEF), CV events, CV mortality, and all-cause mortality in patients with OSA. Nine articles (n = 9610 patients) were analyzed. Four different meta-analyses were performed: evaluation of LVEF, assessment of all-cause mortality, CV mortality, and CV events...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#20
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
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