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Adaptive Servo Ventilation

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https://www.readbyqxmd.com/read/29471442/estimation-of-adaptive-ventilation-success-and-failure-using-polysomnogram-and-outpatient-therapy-biomarkers
#1
Stacey Gunn, Sreelatha Naik, Matt Travis Bianchi, Robert Joseph Thomas
Study Objectives: Adaptive servo ventilation (ASV) devices provide anti-cyclic pressure support for treatment of central/complex sleep apnea, including in heart failure patients. Variability in responses in the clinic and negative clinical trials motivated assessment of standard and novel signal biomarkers for ASV efficacy. Methods: Multiple clinical databases were queried to assess potential signal biomarkers of ASV effectiveness, including 1) Attended laboratory adaptive ventilation titrations: 108, of which 66 had mainstream ETCO2 measurements...
February 17, 2018: Sleep
https://www.readbyqxmd.com/read/29458746/stridor-combined-with-other-sleep-breathing-disorders-in-multiple-system-atrophy-a-tailored-treatment
#2
Saleheddine Rekik, Francis Martin, Pauline Dodet, Stefania Redolfi, Smaranda Leu-Semenescu, Jean-Christophe Corvol, David Grabli, Isabelle Arnulf
OBJECTIVES: To determine the frequency of sleep breathing disorders in multiple systemic atrophy (MSA, combining Parkinsonism, cerebellar syndrome, and dysautonomia) and evaluate the benefit/tolerance of various modes of ventilation. METHODS: We retrospectively analyzed 45 patients with MSA having undergone a videopolysomnography. Their sleep characteristics were compared to those of 45 patients with Parkinson's disease and 45 healthy controls, matched for age and sex...
February 2018: Sleep Medicine
https://www.readbyqxmd.com/read/29372314/adaptive-servo-ventilation-and-sleep-quality-in-treatment-emergent-central-sleep-apnea-and-central-sleep-apnea-in-patients-with-heart-disease-and-preserved-ejection-fraction
#3
Katharina Heider, Michael Arzt, Christoph Lerzer, Leonie Kolb, Michael Pfeifer, Lars S Maier, Florian Gfüllner, Maximilian Valentin Malfertheiner
BACKGROUND: Reduced sleep quality is associated with impaired quality of life and increased mortality in patients with heart failure. The aim of this study was to observe changes in sleep fragmentation and sleep quality in patients with heart disease and preserved left ventricular ejection fraction (pEF) treated with adaptive servo-ventilation (ASV) therapy for treatment of emergent central sleep apnea (TECSA) or central sleep apnea (CSA). METHODS: 114 patients with structural heart disease and pEF introduced to ASV therapy between 2010 and 2015 were retrospectively analyzed...
January 25, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29357095/beneficial-effects-of-adaptive-servo-ventilation-therapy-on-readmission-and-medical-costs-in-patients-with-chronic-heart-failure
#4
Go Hiasa, Hideki Okayama, Saki Hosokawa, Tetsuya Kosaki, Go Kawamura, Tatsuya Shigematsu, Tatsunori Takahashi, Yoshitaka Kawada, Tadakatsu Yamada, Hiroshi Matsuoka, Makoto Saito, Takumi Sumimoto, Yukio Kazatani
Adaptive servo-ventilation (ASV) therapy is a novel modality of noninvasive positive pressure ventilation and is now widely utilized to treat patients with chronic heart failure (CHF). However, there has been no clinical study of the effect of ASV therapy on readmission and cost-effectiveness for the treatment of CHF. The present study was conducted to evaluate the clinical efficacy and cost-effectiveness of home ASV therapy in 45 patients with a history of two or more admissions a year for worsening CHF. Seven patients refused to undergo chronic ASV therapy and three died...
January 22, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#5
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
January 16, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29218014/acute-effects-of-positive-airway-pressure-on-functional-mitral-regurgitation-in-patients-with-systolic-heart-failure
#6
Takao Kato, Takatoshi Kasai, Shoichiro Yatsu, Azusa Murata, Hiroki Matsumoto, Shoko Suda, Masaru Hiki, Nanako Shiroshita, Mitsue Kato, Fusae Kawana, Sakiko Miyazaki, Hiroyuki Daida
Background: Acute effects of positive airway pressure (PAP) [including continuous PAP (CPAP) and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR) in patients with heart failure (HF) with left ventricular (LV) systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated. Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF) <50% (14 men; mean LVEF, 35...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29200833/positive-airway-pressure-adherence-and-subthreshold-adherence-in-posttraumatic-stress-disorder-patients-with-comorbid-sleep-apnea
#7
Barry J Krakow, Jessica J Obando, Victor A Ulibarri, Natalia D McIver
Study objectives: Patients with comorbid posttraumatic stress disorder (PTSD) and obstructive sleep apnea (OSA) manifest low adherence to continuous positive airway pressure (CPAP) due to fixed, pressure-induced expiratory pressure intolerance (EPI), a subjective symptom and objective sign aggravated by anxiety sensitivity and somatosensory amplification. As advanced PAP therapy modes (ie, auto-bilevel PAP [ABPAP] or adaptive servo-ventilation [ASV]) may address these side effects, we hypothesized such treatment would be associated with decreased expiratory intolerance and increased adherence in posttraumatic stress patients with co-occurring OSA...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29193576/adaptive-servo-ventilation-for-central-sleep-apnoea-in-systolic-heart-failure-results-of-the-major-substudy-of-serve-hf
#8
Martin R Cowie, Holger Woehrle, Karl Wegscheider, Eik Vettorazzi, Susanne Lezius, Wolfgang Koenig, Frank Weidemann, Gillian Smith, Christiane Angermann, Marie-Pia d'Ortho, Erland Erdmann, Patrick Levy, Anita K Simonds, Virend K Somers, Faiez Zannad, Helmut Teschler
AIMS: The SERVE-HF trial investigated the impact of treating central sleep apnoea (CSA) with adaptive servo-ventilation (ASV) in patients with systolic heart failure. A preplanned substudy was conducted to provide insight into mechanistic changes underlying the observed effects of ASV, including assessment of changes in left ventricular function, ventricular remodelling, and cardiac, renal and inflammatory biomarkers. METHODS AND RESULTS: In a subset of the 1325 randomised patients, echocardiography, cardiac magnetic resonance imaging (cMRI) and biomarker analysis were performed at baseline, and 3 and 12 months...
November 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29181786/early-therapeutic-effects-of-adaptive-servo-ventilation-on-cardiac-sympathetic-nervous-function-in-patients-with-heart-failure-evaluated-using-a-combination-of-11c-hed-pet-and-123i-mibg-spect
#9
Yusuke Tokuda, Mamoru Sakakibara, Keiichiro Yoshinaga, Shiro Yamada, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Keiji Noguchi, Osamu Manabe, Nagara Tamaki, Hiroyuki Tsutsui
RATIONALE: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57...
November 27, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29174288/-update-on-the-respiratory-management-of-patients-with-chronic-neuromuscular-disease
#10
REVIEW
P Priou, W Trzepizur, N Meslier, F Gagnadoux
BACKGROUND: Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). SURVEILLANCE AND PULMONARY FUNCTION TESTS: For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency...
November 21, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29162360/sleep-disordered-breathing-in-heart-failure-the-state-of-the-art-after-the-serve-hf-trial
#11
REVIEW
João Carmo, Inês Araújo, Filipa Marques, Cândida Fonseca
Heart failure (HF) is one of the most prevalent conditions worldwide and despite therapeutic advances, its prognosis remains poor. Among the multiple comorbidities in HF, sleep-disordered breathing (SDB) is frequent and worsens the prognosis. Preliminary observational studies suggested that treatment of SDB could modify the prognosis of HF, and the issue has gained importance in recent years. The diagnosis of SDB is expensive, slow and suboptimal, and there is thus a need for screening devices that are easier to use and validated in this population...
November 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29108606/positive-airway-pressure-device-technology-past-and-present-what-s-in-the-black-box
#12
REVIEW
Lee K Brown, Shahrokh Javaheri
Since the introduction of continuous positive airway pressure (PAP) for the treatment of obstructive sleep apnea (OSA) in 1981, PAP technology has diversified exponentially. Compact and quiet fixed continuous PAP flow generators, autotitrating PAP devices, and bilevel PAP devices that can treat multiple sleep-disordered breathing phenotypes including OSA, central sleep apnea (CSA), combinations of OSA and CSA, and hypoventilation are available. Adaptive servo-ventilators can suppress Hunter-Cheyne-Stokes breathing and CSA and treat coexisting obstructive events...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28860264/adaptive-servo-ventilation-for-central-sleep-apnoea-in-heart-failure-serve-hf-on-treatment-analysis
#13
Holger Woehrle, Martin R Cowie, Christine Eulenburg, Anna Suling, Christiane Angermann, Marie-Pia d'Ortho, Erland Erdmann, Patrick Levy, Anita K Simonds, Virend K Somers, Faiez Zannad, Helmut Teschler, Karl Wegscheider
This on-treatment analysis was conducted to facilitate understanding of mechanisms underlying the increased risk of all-cause and cardiovascular mortality in heart failure patients with reduced ejection fraction and predominant central sleep apnoea randomised to adaptive servo ventilation versus the control group in the SERVE-HF trial.Time-dependent on-treatment analyses were conducted (unadjusted and adjusted for predictive covariates). A comprehensive, time-dependent model was developed to correct for asymmetric selection effects (to minimise bias)...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28822020/polysomnographic-determinants-of-requirement-for-advanced-positive-pressure-therapeutic-options-for-obstructive-sleep-apnea
#14
Anupama Gupta, Garima Shukla
BACKGROUND: A small percentage of adult patients with severe obstructive sleep apnea (OSA) has been recognized to be extraordinarily difficult to treat with conventional continuous or Bi-level positive airway pressure (together referred to as PAP) therapy. AIM AND OBJECTIVES: The aim of this study was to determine polysomnographic (PSG) characteristics, which may help predict the requirement for advanced therapeutic options for OSA. METHODS: Consecutive patients who underwent PAP titration at our sleep laboratory over a 2-year period were included...
August 18, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28808861/epidemiology-of-sleep-disordered-breathing-and-heart-failure-what-drives-what
#15
REVIEW
Sushma M Dharia, Lee K Brown
PURPOSE OF REVIEW: The bidirectional relationships that have been demonstrated between heart failure (HF) and central sleep apnea (CSA) demand further exploration with respect to the implications that each condition has for the other. This review discusses the body of literature that has accumulated on these relationships and how CSA and its potential treatment may affect outcomes in patients with CSA. RECENT FINDINGS: Obstructive sleep apnea (OSA) can exacerbate hypertension, type 2 diabetes, obesity, and atherosclerosis, which are known predicates of HF...
October 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28777366/-complex-sleep-apnea-syndrome
#16
A D Palman
Complex sleep apnea syndrome (Comp-SAS) is the term used to describe a specific form of sleep disordered breathing characterized by the arise of central sleep apnea in patient with previous obstructive sleep apnea syndrome (OSAS) treated with continuous positive airway pressure devices (CPAP). The mechanisms of its occurrence are not well understood, but partly it seems to be a consequence of increased carbon dioxide elimination under positive airway pressure treatment and related improvement of pulmonary ventilation...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28765411/heart-failure-what-s-new-and-what-s-changed
#17
Paul D Callan, Andrew L Clark
Physicians responsible for the care of patients with heart failure due to left ventricular systolic dysfunction have access to a broad range of evidence-based treatments that prolong life and reduce symptoms. In spite of the significant progress made over the last four decades, there is an ongoing need for novel therapies to treat a condition that is associated with stubbornly high morbidity and mortality. In this article, we discuss the findings of SERVE-HF, a randomised controlled trial of adaptive servo-ventilation in patients with left ventricular systolic dysfunction, as well as EMPA-REG, a study of the effects of a novel diabetic agent that may be of greater interest to heart failure specialists than diabetologists...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28701680/right-ventricular-end-diastolic-pressure-is-a-key-to-the-changes-in-cardiac-output-during-adaptive-servo-ventilation-support-in-patients-with-heart-failure
#18
Teruhiko Imamura, Koichiro Kinugawa
Adaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. ΔLeft ventricular end-diastolic pressure (LVEDP) did not correlate with ΔCI, whereas Δtransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and ΔCI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0...
August 3, 2017: International Heart Journal
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
#19
REVIEW
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/28671174/case-of-postural-complex-sleep-apnea-effect-of-gravitational-forces
#20
Kamender Singh Pawar, Abhishek Goyal, Alkesh Khurana, Senthil Kumar, Amit Kumar Sen
We report a case of an elderly male with predominant obstructive sleep apnea and who developed or complex sleep apnea (CxSA) at the start of continuous positive airway pressure (CPAP) titration. This CxSA was more prominent in supine position, and he was not settling with either CPAP/bilevel positive airway pressure (PAP) in supine position. He finally settled with CPAP along with position therapy. This case highlights the importance of treating CxSA with basic PAP modes like CPAP along with positional therapy before switching to costlier therapies such as adaptive servo-ventilation...
July 2017: Lung India: Official Organ of Indian Chest Society
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