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https://www.readbyqxmd.com/read/29327943/phenotyping-pharyngeal-pathophysiology-using-polysomnography-in-patients-with-obstructive-sleep-apnea
#1
Scott A Sands, Bradley A Edwards, Philip I Terrill, Luigi Taranto-Montemurro, Ali Azarbarzin, Melania Marques, Lauren Hess, David P White, Andrew Wellman
RATIONALE: Therapies for obstructive sleep apnea (OSA) could be administered based on a patient's own phenotypic causes ("traits") if a clinically-applicable approach were available. Here we present a novel approach to quantify two key contributors to OSA-pharyngeal collapsibility and compensatory muscle responsiveness-that is applicable to diagnostic polysomnography. METHODS: Based on physiological definitions, pharyngeal collapsibility determines the ventilation at normal (eupneic) ventilatory drive during sleep, and pharyngeal compensation determines the rise in ventilation accompanying a rising ventilatory drive...
January 12, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29288162/retrospective-consent-in-a-neonatal-randomized-controlled-trial
#2
Nils T Songstad, Calum T Roberts, Brett J Manley, Louise S Owen, Peter G Davis
BACKGROUND AND OBJECTIVES: The requirement for prospective consent in clinical trials in acute settings may result in samples unrepresentative of the study population, potentially altering study findings. However, using retrospective consent may raise ethical issues. We assessed whether using retrospective consent affected recruitment, participant characteristics, and outcomes within a randomized controlled trial. METHODS: We conducted a secondary analysis of a randomized trial, which compared nasal high flow (nHF) with nasal continuous positive airway pressure (CPAP) for primary respiratory support in preterm infants...
December 29, 2017: Pediatrics
https://www.readbyqxmd.com/read/29273515/nasal-versus-oronasal-cpap-for-obstructive-sleep-apnea-treatment-a-meta-analysis
#3
Rafaela G S Andrade, Fernanda M Viana, Juliana A Nascimento, Luciano F Drager, Adriano Moffa, André R Brunoni, Pedro R Genta, Geraldo Lorenzi-Filho
BACKGROUND: Nasal continuous positive airway pressure (CPAP) is the gold standard treatment for obstructive sleep apnea (OSA). However, oronasal masks are frequently used in clinical practice. The aim of this study was to perform a meta-analysis of all randomized and non-randomized trials that compared nasal versus oronasal masks on CPAP level, residual apnea-hypopnea index (AHI) and CPAP adherence to treat OSA. METHODS: Cochrane Central Register of Controlled Trials, Medline and Web of Science were searched for relevant studies in any language with the following terms: "sleep apnea" AND "CPAP" OR "sleep apnea" AND "oronasal mask" OR "OSA" AND "oronasal CPAP" OR "oronasal mask" AND "adherence"...
December 19, 2017: Chest
https://www.readbyqxmd.com/read/29228393/quantifying-the-arousal-threshold-using-polysomnography-in-obstructive-sleep-apnea
#4
Scott A Sands, Philip I Terrill, Bradley A Edwards, Luigi Taranto Montemurro, Ali Azarbarzin, Melania Marques, Camila M de Melo, Stephen H Loring, James P Butler, David White, Andrew Wellman
Objectives: Precision medicine for obstructive sleep apnea (OSA) requires non-invasive estimates of each patient's pathophysiological "traits". Here we provide the first, automated technique to quantify the respiratory arousal threshold-defined as the level of ventilatory drive triggering arousal from sleep-using diagnostic polysomnographic signals in patients with OSA. Methods: Ventilatory drive preceding clinically-scored arousals was estimated from polysomnographic studies by fitting a respiratory control model (Terrill P et al...
November 9, 2017: Sleep
https://www.readbyqxmd.com/read/29210760/a-pilot-study-of-responses-to-suctioning-among-neonates-on-bubble-nasal-continuous-positive-airway-pressure
#5
Michele Sweet, Debra Armbruster, Erin Bainbridge, Brianna Reiner, Alai Tan, Esther Chipps
BACKGROUND: Maintenance of a patent airway while the neonate is on nasal continuous positive airway pressure (nasal CPAP) requires vigilant monitoring and oral/nasopharyngeal suctioning. Currently, no evidence-based guidelines for safe suctioning in neonates while on bubble nasal CPAP have been published. PURPOSE: (1) To characterize the clinical and behavioral responses of neonates on bubble nasal CPAP in a level III neonatal intensive care unit following routine oral and nasopharyngeal suctioning...
December 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29198305/comparing-the-efficacy-mask-leak-patient-adherence-and-patient-preference-of-three-different-cpap-interfaces-to-treat-moderate-severe-obstructive-sleep-apnea
#6
Sharn Rowland, Vinod Aiyappan, Cathy Hennessy, Peter Catcheside, Ching Li Chai-Coezter, R Doug McEvoy, Nick A Antic
STUDY OBJECTIVES: To determine if the type of continuous positive airway pressure (CPAP) mask interface influences CPAP treatment efficacy, adherence, side effects, comfort and sleep quality in patients with moderate-severe obstructive sleep apnea (OSA). METHODS: This took place in a hospital-based tertiary sleep disorders unit. It is a prospective, randomized, crossover trial comparing three CPAP interfaces: nasal mask (NM), nasal mask plus chinstrap (NM-CS) and oronasal mask (ONM) each tried in random order, for 4 weeks...
November 29, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29196149/continuous-positive-airway-pressure-treatment-with-nasal-pillows-in-obstructive-sleep-apnea-long-term-effectiveness-and-adherence
#7
Andrea Lanza, Sara Mariani, Maurizio Sommariva, Chiara Campana, Annalisa Rubino, Michele Nichelatti, Paola Proserpio, Lino Nobili
BACKGROUNDS: Mask-related side effects can negatively influence adherence to continuous positive airway pressure (CPAP). Nasal pillows (P) can be an alternative to the standard nasal masks (N), although there are no data about their long-term efficacy. This study aimed to assess long-term effectiveness and adherence to CPAP therapy delivered with nasal pillows in obstructive sleep apnea syndrome (OSAS) patients. METHODS: A retrospective observational design involving a series of consecutive CPAP-naïve patients affected by OSAS...
October 12, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#8
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29157171/effect-of-changes-in-periodic-limb-movements-under-cpap-on-adherence-and-long-term-compliance-in-obstructive-sleep-apnea
#9
Gimbada B Mwenge, Ihsan Rougui, Daniel Rodenstein
Purpose of the study Periodic leg movements (PLMs) are found in 30% of patients suffering from OSA. Under CPAP, we observed that PLMs can increase, decrease, or remain unchanged. The predictors of these changes are not well established. Objective To determine the predictors of PLMs change under CPAP and its impact on long-term adherence. Materials and method The patients were referred to the sleep laboratory for snoring or sleepiness. A single PSG night has been performed before and after CPAP treatment. Data on medication used, comorbidities and ferritin level were collected...
November 20, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29149468/pneumoparotitis-as-a-complication-of-long-term-oronasal-positive-airway-pressure-for-sleep-apnea
#10
Andrew J Goates, Daniel J Lee, Joan E Maley, Phillip C Lee, Henry T Hoffman
BACKGROUND: Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation. METHODS: We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea...
November 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/29095428/how-does-high-flow-nasal-cannulae-compare-to-nasal-cpap-for-treatment-of-early-respiratory-distress
#11
S Parmekar, J Hagan
No abstract text is available yet for this article.
November 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29072676/comparison-of-sprinting-vs-non-sprinting-to-wean-nasal-continuous-positive-airway-pressure-off-in-very-preterm-infants
#12
N Eze, D Murphy, V Dhar, V K Rehan
OBJECTIVE: Though nasal continuous positive airway pressure (NCPAP) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning NCPAP is not established. In this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off NCPAP increases successful weaning from NCPAP in infants born <31 weeks gestational age. STUDY DESIGN: Infants were randomized to one of the two NCPAP weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off CPAP, protocol vs a non-sprinting (weaning pressure down) protocol...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29066587/heart-rate-variability-in-extremely-preterm-infants-receiving-nasal-cpap-and-non-synchronized-noninvasive-ventilation-immediately-after-extubation
#13
Samantha Latremouille, Ali Al-Jabri, Philippe Lamer, Lara Kanbar, Wissam Shalish, Robert E Kearney, Guilherme M Sant'Anna
INTRODUCTION: There is a paucity of studies comparing the physiological effects of nasal CPAP or non-synchronized noninvasive ventilation (ns-NIV) during the postextubation phase in preterm infants. Heart rate variability (HRV) can identify system instability before clinical or laboratory signs of deterioration. Thus, we sought to investigate any differences in HRV between those modes. METHODS: 15 preterm infants with birthweight ≤1,250 g and undergoing their first extubation attempt were studied immediately after disconnection from mechanical ventilation...
January 2018: Respiratory Care
https://www.readbyqxmd.com/read/29059008/narrative-review-of-contemporary-treatment-options-in-the-care-of-patients-with-obstructive-sleep-apnoea
#14
Mark S Ferguson, Jennifer Claire Magill, Bhik T Kotecha
Snoring and obstructive sleep apnoea (OSA) are increasingly common conditions, and confer a significant health and socioeconomic burden. Furthermore, untreated OSA represents a significant mortality risk. Patients require careful assessment, including detailed clinical history and examination, sleep study and drug-induced sleep endoscopy (DISE). Although nasal continuous positive airway pressure (nCPAP) is the gold standard treatment for moderate and severe OSA, multidisciplinary team assessment is often required to develop the best treatment plan for an individual, especially when nasal CPAP is poorly tolerated...
October 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#15
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28977653/to-compare-the-efficacy-of-heated-humidified-high-flow-nasal-cannula-and-continuous-positive-airway-pressure-in-post-extubation-period-in-vlbw-infants
#16
Bhawan Deep Garg, Naveen Bajaj, Deepak Sharma
Objective: The objective of this study was to compare efficacy of continuous positive airway pressure (CPAP) and heated humidified high-flow nasal cannula (HHHFNC) as noninvasive respiratory support in post-extubation period in very low birth weight (VLBW) infants. Method: This retrospective study enrolled 136 neonates, ≤32 weeks gestation and ≤1500 grams birth weight, requiring noninvasive respiratory support during post-extubation period. Results: There was no significant difference in post-extubation failure in HHHFNC group when compared with CPAP group ( p  > 0...
August 8, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28966735/continuous-positive-airway-pressure-is-it-a-route-for-infection-in-those-with-obstructive-sleep-apnoea
#17
Liam Mercieca, Richard Pullicino, Kyra Camilleri, Rodianne Abela, Sean Apap Mangion, Julian Cassar, Matthew Zammit, Christine Gatt, Christopher Deguara, Christopher Barbara, Peter Fsadni, Stephen Montefort
INTRODUCTION: Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnoea (OSA), with limited data about the prevalence of respiratory infections and microbial colonization in these patients. OBJECTIVES: The aim of this study was to determine if CPAP use is associated with respiratory infections and to identify the organisms that colonize or infect these patients. METHOD: A retrospective, case-controlled study in patients diagnosed with OSA was carried out...
January 2017: Sleep Science
https://www.readbyqxmd.com/read/28966076/sleep-apnea-metabolic-disease-and-the-cutting-edge-of-therapy
#18
Matthew Light, Karen McCowen, Atul Malhotra, Omar A Mesarwi
Obstructive sleep apnea (OSA) is common, and many cross-sectional and longitudinal studies have established OSA as an independent risk factor for the development of a variety of adverse metabolic disease states, including hypertension, insulin resistance, type 2 diabetes, nonalcoholic fatty liver disease, dyslipidemia, and atherosclerosis. Nasal continuous positive airway pressure (CPAP) has long been the mainstay of therapy for OSA, but definitive studies demonstrating the efficacy of CPAP in improving metabolic outcomes, or in reducing incident disease burden, are lacking; moreover, CPAP has variable rates of adherence...
September 28, 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28943321/a-randomized-pilot-study-comparing-the-role-of-peep-o2-flow-and-high-flow-air-for-weaning-of-ventilatory-support-in-very-low-birth-weight-infants
#19
Chang-Yo Yang, Mei-Chin Yang, Shih-Ming Chu, Ming-Chou Chiang, Reyin Lien
BACKGROUND: There is a lack of evidence to guide step-wise weaning of positive pressure respiratory support for premature infants. This study sought to compare the efficacy of three weaning protocols we designed to facilitate weaning of very low birth weight (VLBW, less than 1500 g) preterm infants from nasal continuous positive airway pressure (NCPAP) support. METHODS: This was a prospective, randomized, controlled trial of VLBW preterm infants who received positive pressure ventilatory support in our neonatal intensive care unit (NICU) from April 2008 through March 2009...
September 6, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28938361/columellar-reconstruction-following-nasal-cpap-injury
#20
Catherine S Chang, Jordan W Swanson, Anthony Wilson, David W Low, Scott P Bartlett
Nasal continuous positive airway pressure (nCPAP) is utilized increasingly to treat pulmonary immaturity in premature neonates. Nasal injury is common with nCPAP use, with full thickness tissue loss at the columella among the most devastating complications.Columellar necrosis often imparts a full thickness injury to the overlying columellar skin, the medial crura of the lower lateral nasal cartilages, as well as the anteromedial inner nasal mucosal lining, and potentially the anterior septal cartilage. Consequently, the columella can become scarred and shortened...
September 15, 2017: Plastic and Reconstructive Surgery
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