Acute Effects of Continuous Positive Airway Pressure on Pulse Pressure in Chronic Heart Failure

Quintão, Mônica; Chermont, Sérgio; Marchese, Luana; Brandão, L; Bernardez, Sabrina; Mesquita, Evandro Tinoco; Rocha, Nazareth de Novaes; Nóbrega, Antônio Cláudio Lucas da

doi:10.5935/abc.20140006

Cited by 4 publications

(3 citation statements)

References 36 publications

(47 reference statements)

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“…Patients submitted to CPAP had a decrease in pulse pressure correlated to an increase in the ejection fraction originated by the reduction of the transmural pressure. 35 …”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Bittencourt¹,

Reis²,

Lima³

et al. 2017

Arquivos Brasileiros De Cardiologia

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Non-invasive ventilation (NIV) may perfect respiratory and cardiac performance in patients with heart failure (HF).The objective of the study to establish, through systematic review and meta-analysis, NIV influence on functional capacity of HF patients.A systematic review with meta-analysis of randomized studies was carried out through research of databases of Cochrane Library, SciELO, Pubmed and PEDro, using the key-words: heart failure, non-invasive ventilation, exercise tolerance; and the free terms: bi-level positive airway pressure (BIPAP), continuous positive airway pressure (CPAP), and functional capacity (terms were searched for in English and Portuguese) using the Boolean operators AND and OR. Methodological quality was ensured through PEDro scale. Weighted averages and a 95% confidence interval (CI) were calculated. The meta-analysis was done thorugh the software Review Manager, version 5.3 (Cochrane Collaboration).Four randomized clinical trials were included. Individual studies suggest NIV improved functional capacity. NIV resulted in improvement in the distance of the six-minute walk test (6MWT) (68.7m 95%CI: 52.6 to 84.9) in comparison to the control group.We conclude that the NIV is an intervention that promotes important effects in the improvement of functional capacity of HF patients. However, there is a gap in literature on which are the most adequate parameters for the application of this technique.

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“…Patients submitted to CPAP had a decrease in pulse pressure correlated to an increase in the ejection fraction originated by the reduction of the transmural pressure. 35 …”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Bittencourt¹,

Reis²,

Lima³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“…Another issue requiring further study is the ideal positive pressure to promote increased exercise tolerance. Some authors advocate a CPAP value of 10 cmH 2 O 37 because it promotes alveolar recruitment and effective gas exchange, whilst others advocate smaller values, namely 6 cmH 2 O or the value best tolerated by patients 4 , 38 because a significant improvement in cardiac output is shown with low levels of CPAP.…”

Section: Discussionmentioning

confidence: 99%

Noninvasive ventilation and exercise tolerance in heart failure: A systematic review and meta-analysis

Bündchen¹,

Gonzáles²,

Noronha³

et al. 2014

Braz. J. Phys. Ther.

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Background: Patients with heart failure (HF) usually develop exercise intolerance. In this context, noninvasive ventilation (NIV) can help to increase physical performance. Objective:To undertake a systematic review and meta-analysis of randomized controlled trials that evaluated the effects of NIV on exercise tolerance in patients with HF. Method: Search Strategy: Articles were searched in the following databases: Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and MEDLINE. Selection Criteria: This review included only randomized controlled trials involving patients with HF undergoing NIV, with or without other therapies, that used exercise tolerance as an outcome, verified by the distance travelled in the six-minute walk test (6MWT), VO2peak in the cardiopulmonary test, time spent in testing, and dyspnea. Data Collection and Analysis: The methodological quality of the studies was rated according to the PEDro scale. Data were pooled in fixed-effect meta-analysis whenever possible. Results: Four studies were selected. A meta-analysis including 18 participants showed that the use of NIV prior to the 6MWT promoted increased distance, [mean difference 65.29 m (95% CI 38.80 to 91.78)]. Conclusions:The use of NIV prior to the 6MWT in patients with HF may promote increased distance. However, the limited number of studies may have compromised a more definitive conclusion on the subject.

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“…Timely delivered PAP therapy appears to have beneficial effects on patients with OSA in the general population ( 39 , 40 ), ischemic stroke and TIA ( 41 – 43 ), epilepsy ( 44 – 46 ), HTN ACS/MI ( 47 – 50 ), atrial fibrillation ( 51 – 53 ), CHF ( 54 – 56 ), TBI ( 26 ), multiple sclerosis ( 27 ), PD ( 57 ), Alzheimer's dementia ( 35 , 58 – 60 ) and neuromuscular conditions ( 61 , 62 ), and ALS ( 16 , 62 – 65 ).…”

Section: Introductionmentioning

confidence: 99%

The mobile sleep medicine model in neurologic practice: Rationale and application

2022

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BackgroundUndiagnosed obstructive sleep apnea (OSA) is prevalent in neurological practice and significantly contributes to morbidity and mortality. OSA is prevalent in US adults and causes poor quality sleep and significant neurocognitive, cardiovascular, and cerebrovascular impairments. Timely treatment of OSA reduces cardio-cerebrovascular risks and improves quality of life. However, most of the US population has limited systematic access to sleep medicine care despite its clinical significance.FocusWe discuss the importance of systematic screening, testing, and best-practice management of OSA and hypoventilation/hypoxemia syndromes (HHS) in patients with stroke, neurocognitive impairment, and neuromuscular conditions. This review aims to introduce and describe a novel integrated Mobile Sleep Medicine (iMSM) care model and provide the rationale for using an iMSM in general neurological practice to assist with systematic screening, testing and best-practice management of OSA, HHS, and potentially other sleep conditions.Key pointsThe iMSM is an innovative, patient-centered, clinical outcome-based program that uses a Mobile Sleep Medicine Unit—a “sleep lab on wheels”—designed to improve access to OSA management and sleep care at all levels of health care system. The protocol for the iMSM care model includes three levels of operations to provide effective and efficient OSA screening, timely testing/treatment plans, and coordination of further sleep medicine care follow-up. The iMSM care model prioritizes effective, efficient, and patient-centered sleep medicine care; therefore, all parties and segments of care that receive and provide clinical sleep medicine services may benefit from adopting this innovative approach.

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Acute Effects of Continuous Positive Airway Pressure on Pulse Pressure in Chronic Heart Failure

Cited by 4 publications

References 36 publications

Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Non-Invasive Ventilation in Patients with Heart Failure: A Systematic Review and Meta-Analysis

Noninvasive ventilation and exercise tolerance in heart failure: A systematic review and meta-analysis

The mobile sleep medicine model in neurologic practice: Rationale and application

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