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https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#1
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Noninvasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV) and nasal bilevel CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28714534/adjustable-thermoplastic-oral-appliance-versus-positive-airway-pressure-for-obstructive-sleep-apnea
#2
Wish Banhiran, Paraya Assanasen, Cherdchai Nopmaneejumrudlers, Nongyoaw Nujchanart, Wimontip Srechareon, Cheerasook Chongkolwatana, Choakchai Metheetrairut
OBJECTIVES/HYPOTHESIS: To compare outcomes of continuous positive airway pressure (CPAP) and the adjustable thermoplastic mandibular advancement splint (AT-MAS) for obstructive sleep apnea treatment. STUDY DESIGN: Randomized crossover, noninferiority, tertiary center setting. METHODS: Fifty patients with a mean age of 49.5 ± 10.6 years were enrolled. Inclusion criteria were age ≥18 years, apnea-hypopnea index (AHI) ≥5 events/hour, and oxygen saturation ≥70%...
July 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28705995/reproducibility-of-airway-luminal-size-in-asthma-measured-by-hrct
#3
Robert H Brown, Robert J Henderson, Elizabeth A Sugar, Janet T Holbrook, Robert A Wise
High resolution computed tomography (HRCT) is a well-established imaging technology to measure lung and airway morphology in vivo. However, there is a surprising lack of studies examining HRCT reproducibility. The CPAP trial was a multicenter, randomized, 3-parallel arm, sham-controlled 12 week clinical trial to assess the use of a nocturnal CPAP device on airways reactivity to methacholine. The lack of a treatment effect of CPAP on clinical or HRCT measures provided an opportunity for the current analysis...
July 13, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28701992/verifying-the-relative-efficacy-between-continuous-positive-airway-pressure-therapy-and-its-alternatives-for-obstructive-sleep-apnea-a-network-meta-analysis
#4
Tingwei Liu, Wenyang Li, Hui Zhou, Zanfeng Wang
Obstructive sleep apnea (OSA) is a common breathing disorder, and continuous positive airway pressure (CPAP) therapy together with its alternatives has been developed to treat this disease. This network meta-analysis (NMA) was aimed to compare the efficacy of treatments for OSA. Cochrane Library, MEDLINE, and Embase were searched for eligible studies. A conventional and NMA was carried out to compare all therapies. Sleeping characteristics, including Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), arterial oxygen saturation, and arousal index (AI), and changes of blood pressure were selected as outcomes...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#5
REVIEW
Justin C Brockbank
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28697288/obstructive-sleep-apnoea-and-obesity
#6
Garun S Hamilton, Simon A Joosten
BACKGROUND: Obstructive sleep apnoea (OSA) and obesity are two common conditions affecting the Australian population; obesity is the major risk factor for OSA. OBJECTIVE: The objectives of this article are to review the interactions between obesity and OSA, including the increased cardiovascular risk, and highlight the importance of using OSA diagnosis as a critical time to address obesity itself and other cardiovascular risk factors. DISCUSSION: Snoring and symptoms of OSA frequently worsen during periods of rapid weight gain...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28697252/association-of-positive-airway-pressure-with-cardiovascular-events-and-death-in-adults-with-sleep-apnea-a-systematic-review-and-meta-analysis
#7
Jie Yu, Zien Zhou, R Doug McEvoy, Craig S Anderson, Anthony Rodgers, Vlado Perkovic, Bruce Neal
Importance: Sleep apnea (obstructive and central) is associated with adverse cardiovascular risk factors and increased risks of cardiovascular disease. Positive airway pressure (PAP) provides symptomatic relief, whether delivered continuously (CPAP) or as adaptive servo-ventilation (ASV), but the associations with cardiovascular outcomes and death are unclear. Objective: To assess the association of PAP vs control with cardiovascular events and death in patients with sleep apnea...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28689679/non-invasive-mechanical-ventilation-versus-continuous-positive-airway-pressure-relating-to-cardiogenic-pulmonary-edema-in-an-intensive-care-unit
#8
Alberto Belenguer-Muncharaz, Lidón Mateu-Campos, Rubén González-Luís, Bárbara Vidal-Tegedor, Amparo Ferrándiz-Sellés, Joaquín Árguedas-Cervera, Susana Altaba-Tena, Patricia Casero-Roig, Ester Moreno-Clarí
BACKGROUND: To compare the application of non-invasive ventilation (NIV) versus continuous positive airway pressure (CPAP) in the treatment of patients with cardiogenic pulmonary edema (CPE) admitted to an intensive care unit (ICU). METHODS: In a prospective, randomized, controlled study performed in an ICU, patients with CPE were assigned to NIV (n=56) or CPAP (n=54). Primary outcome was intubation rate. Secondary outcomes included duration of ventilation, length of ICU and hospital stay, improvement of gas exchange, complications, ICU and hospital mortality, and 28-day mortality...
July 6, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28684586/exposure-to-intermittent-hypoxia-and-sustained-hypercapnia-reduces-therapeutic-cpap-in-participants-with-obstructive-sleep-apnea
#9
Mohamad El-Chami, Sukhesh Sudan, Ho-Sheng Lin, Jason H Mateika
PURPOSE: To determine if exposure to mild intermittent hypoxia leads to a reduction in the therapeutic continuous positive airway pressure required to eliminate breathing events. METHODS: Ten male participants were treated with twelve 2-minute episodes of hypoxia (PETO2 ≈ 50 mmHg) separated by 2-minute intervals of normoxia in the presence of PETCO2 that was sustained 3 mmHg above baseline. During recovery from the last episode the positive airway pressure was reduced in a step-wise fashion until flow limitation was evident...
July 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28675961/maxillary-deformity-following-cpap-treatment-in-myasthenia-gravis
#10
Yaron Haviv, Shirley Leibovitz, Galit Almoznino, Yair Sharav, Uri Zilberman
OBJECTIVE: Patients with Myasthenia gravis (MG) are characterized by muscle weakness that may cause obstructive sleep apnea (OSA). The use of a continuous positive airway pressure (CPAP) device is often needed in order to maintain free breathing during the night and sometimes even during the day. CLINICAL PRESENTATION: A 29-year-old MG patient is presented who used a CPAP continuously since the age of 12. Tight fitting of a nasal mask applied enough force to cause severe maxillary deformity...
July 4, 2017: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/28667213/extrapulmonary-effects-of-continuous-airway-pressure-on-patients-with-obstructive-sleep-apnoea-protocol-for-an-overview-of-systematic-reviews
#11
Gonzalo Labarca, Francisco Ortega, Alex Arenas, Tomas Reyes, Gabriel Rada, Jorge Jorquera
INTRODUCTION: Obstructive sleep apnoea (OSA) is associated with both pulmonary and extrapulmonary consequences. Continuous positive airway pressure (CPAP) is an effective treatment for pulmonary symptoms. However, it is not clear if CPAP modifies extrapulmonary symptoms, especially in the long term. To date, several studies addressing this issue have been performed, but the evidence is scattered across different reviews that address each outcome separately. Therefore, we will conduct an overview to assess and summarise all systematic reviews on the extrapulmonary effects of this intervention in patients with OSA...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28665065/prophylactic-versus-early-rescue-surfactant-treatment-in-preterm-infants-born-at-less-than-30-weeks-gestation-or-with-birth-weight-less-than-or-equal-1-250-grams
#12
Jiyoung Chun, Se In Sung, Yo Han Ho, Jisook Kim, Ga Young Park, Shin Ae Yoon, So Yoon Ahn, Yun Sil Chang, Won Soon Park
Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS)...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28664540/maintenance-diets-following-rapid-weight-loss-in-obstructive-sleep-apnea-a-pilot-1-year-clinical-trial
#13
Elizabeth A Cayanan, Nathaniel S Marshall, Camilla M Hoyos, Craig L Phillips, Yasmina Serinel, Keith K H Wong, Brendon J Yee, Ronald R Grunstein
Very low energy diets (VLED) appear to be the most efficacious dietary-based obesity reduction treatments in obstructive sleep apnea (OSA); however, effective weight loss maintenance strategies remain untested in this condition. Our study aimed to assess the feasibility, tolerability and efficacy of two common maintenance diets during a 10-month follow-up period after rapid weight loss using a 2-month VLED. In this two-arm, single-centre, open-label pilot trial, obese adult OSA patients received a 2-month VLED before being allocated to either the Australian Guide to Healthy Eating diet (AGHE) or a low glycaemic index high-protein diet (LGHP)...
June 30, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28651851/meta-analysis-of-cardiovascular-outcomes-with-continuous-positive-airway-pressure-therapy-in-patients-with-obstructive-sleep-apnea
#14
Ahmed S Abuzaid, Haitham S Al Ashry, Ayman Elbadawi, Ha Ld, Marwan Saad, Islam Y Elgendy, Akram Elgendy, Ahmed N Mahmoud, Amgad Mentias, Amr Barakat, Chitra Lal
Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Continuous positive airway pressure (CPAP) is the main treatment of OSA. The present study explores the impact of CPAP on cardiovascular outcomes. A systematic search of electronic databases for randomized controlled trials comparing CPAP with medical therapy alone in patients with OSA who reported cardiovascular outcomes of interest was performed. The main outcome was major adverse cardiac events. Other outcomes included cardiac mortality, myocardial infarction, angina pectoris, stroke, and transient ischemic attack...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28651794/airflow-shape-is-associated-with-the-pharyngeal-structure-causing-obstructive-sleep-apnea
#15
Pedro R Genta, Scott A Sands, James P Butler, Stephen H Loring, Eliot S Katz, B Gail Demko, Eric J Kezirian, David P White, Andrew Wellman
BACKGROUND: Obstructive sleep apnea (OSA) results from the collapse of different pharyngeal structures (soft palate, tongue, lateral walls, epiglottis). The structure involved in collapse has been shown to impact non-CPAP OSA treatment. Different inspiratory airflow shapes are also observed among OSA patients. We hypothesized that inspiratory flow shape reflects the underlying pharyngeal structure involved in airway collapse. METHODS: Subjects with OSA were studied with a pediatric endoscope and simultaneous nasal flow and pharyngeal pressure recordings during natural sleep...
June 23, 2017: Chest
https://www.readbyqxmd.com/read/28649379/is-transoral-robotic-surgery-a-safe-and-effective-multilevel-treatment-for-obstructive-sleep-apnoea-in-obese-patients-following-failure-of-conventional-treatment-s
#16
George Garas, Anthousa Kythreotou, Christos Georgalas, Asit Arora, Bhik Kotecha, Floyd C Holsinger, David G Grant, Neil Tolley
A best evidence topic was written according to a structured protocol. The question addressed was whether TransOral Robotic Surgery (TORS) is a safe and effective multilevel treatment for Obstructive Sleep Apnoea (OSA) in obese patients following failure of conventional treatment(s). A total of 39 papers were identified using the reported searches of which 5 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28648227/the-management-privacy-and-medico-legal-issues-of-electronic-cpap-data-in-australia-and-new-zealand-electronic-cpap-data-management-in-australia-and-new-zealand
#17
John Swieca, Garun S Hamilton, Hailey Meaklim
STUDY OBJECTIVE: Continuous Positive Airway Pressure (CPAP) is considered to be the gold standard treatment for obstructive sleep apnoea (OSA). CPAP monitoring systems allow tracking of patient CPAP adherence and treatment efficacy, by measuring residual sleep-disordered breathing, hours of CPAP use, and mask leak etc. The American Thoracic Society (ATS) published a position paper in 2013 highlighting issues of interpreting CPAP data such as a lack of consistency between CPAP manufacturers data algorithms, legal implications of CPAP data and implications for CPAP adherence...
August 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28645982/a-multicentre-randomised-controlled-non-inferiority-trial-comparing-nasal-high-flow-with-nasal-continuous-positive-airway-pressure-as-primary-support-for-newborn-infants-with-early-respiratory-distress-born-in-australian-non-tertiary-special-care-nurseries
#18
Brett J Manley, Calum T Roberts, Gaston R B Arnolda, Ian M R Wright, Louise S Owen, Kim M Dalziel, Jann P Foster, Peter G Davis, Adam G Buckmaster
INTRODUCTION: Nasal high-flow (nHF) therapy is a popular mode of respiratory support for newborn infants. Evidence for nHF use is predominantly from neonatal intensive care units (NICUs). There are no randomised trials of nHF use in non-tertiary special care nurseries (SCNs). We hypothesise that nHF is non-inferior to nasal continuous positive airway pressure (CPAP) as primary support for newborn infants with respiratory distress, in the population cared for in non-tertiary SCNs. METHODS AND ANALYSIS: The HUNTER trial is an unblinded Australian multicentre, randomised, non-inferiority trial...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28636405/conventional-polysomnography-is-not-necessary-for-the-management-of-most-patients-with-suspected-obstructive-sleep-apnea
#19
Jaime Corral, Maria-Ángeles Sánchez-Quiroga, Carmen Carmona-Bernal, Ángeles Sánchez-Armengol, Alicia Sánchez-de-la-Torre, Joaquín Durán-Cantolla, Carlos J Egea, Neus Salord, Carmen Monasterio, Joaquín Terán, M Luz Alonso-Alvarez, Jesús Muñoz-Méndez, Eva M Arias, Marta Cabello, Josep M Montserrat, Mónica De la Peña, José C Serrano, Ferran Barbe, Juan F Masa
RATIONALE: Home respiratory polygraphy may be a simpler alternative to in-laboratory polysomnography for the management of more symptomatic obstructive sleep apnea patients, but its effectiveness has not been evaluated across a broad clinical spectrum. OBJECTIVE: To compare the long-term effectiveness (6 months) of home respiratory polygraphy and polysomnography management protocols in patients with intermediate to high sleep apnea suspicion (most patients requiring a sleep study)...
June 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28635907/-the-problem-of-obstructive-sleep-apnea-syndrome-in-asthmatic-patients
#20
E G Sheludko, D E Naumov, Yu M Perelman, V P Kolosov
Asthma and obstructive sleep apnea syndrome (OSAS) are one of the most common chronic respiratory diseases. These have common risk factors that include obesity, gastroesophageal reflux disease (GERD) and impaired nasal breathing (allergic rhinitis, sinusitis). At the same time, experimental evidence demonstrates common pathophysiological mechanisms of these diseases, such as involvement in the process of the respiratory tract, a systemic inflammatory response, and implementation of neuromechanical reflexes...
2017: Terapevticheskiĭ Arkhiv
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