Adaptive servo-ventilation in patients with coexisting obstructive sleep apnoea/hypopnoea and Cheyne–Stokes respiration

Effect of Flow-Triggered Adaptive Servo-Ventilation Compared With Continuous Positive Airway Pressure in Patients With Chronic Heart Failure With Coexisting Obstructive Sleep Apnea and Cheyne-Stokes Respiration

“…In particular, the algorithm for flowtriggered ASV allows the application of CPAP (minimal IPAPϭEPAP) and enables one to define the back-up rate individually, whereas the volume-triggered ASV device applies a minimal difference of 3 cm ⅐ H 2 O between minimal IPAP and EPAP and has only an automatic back-up rate. Therefore, flow-triggered ASV is considered to be more practical for normalizing breathing in patients with coexisting OSA and CSR-CSA than volume-triggered ASV, which has been developed with a focus on patients with predominant CSR-CSA, 16,17 even though no studies have compared these 2 devices. Because patients with pure CSR-CSA are rare in the current clinical setting, it might be important to focus on patients with coexisting OSA and CSR-CSA.…”

“…14 Indeed, several groups have reported the efficacy of ASV for suppressing SDB using 2 different types of ASV: volumetriggered ASV, and the newer, flow-triggered ASV, which has been developed based on the concept of normalizing breathing in patients with both OSA and CSR-CSA. [15][16][17] Although several reports have demonstrated the efficacy of volume-triggered ASV for improving device compliance and cardiac function in patients with predominant CSR-CSA, 18 -20 there are no similar data showing such efficacies using flow-triggered ASV. Moreover, no data about the efficacy of ASV for patients with CHF with coexisting OSA and CSR-CSA are available.…”

“…[15][16][17] In summary, the flow-triggered ASV provides a manually set level of expiratory positive airway pressure (EPAP) to maintain upper-airway patency and automatically modulates the inspiratory positive airway pressure (IPAP) within a preset range to maintain a target inspiratory airflow, thereby eliminating CSR-CSA events. In addition, the device provides an automatic back-up rate, should sustained apnea be detected.…”

Complex sleep apnoea syndrome

“…AHI could be normalised with ASV (,5 events?h -1 ) in the majority of CompSAS patients. RANDERATH et al [45] evaluated the effect of ASV in patients with obstructive as well as central apnoeas. The total AHI decreased from 46.8 to 7.8, the central AHI from 25.7 to 7.1 and the obstructive AHI from 14.2 to 0.7.…”

Patient-Ventilator Interaction During Noninvasive Ventilation

“…When breathing resumes and ventilation exceeds the target, pressure support is reduced to the minimum of 3 cm H 2 O. Adaptive servo ventilation has been used primarily in the treatment of patients with sleep-disordered breathing associated with chronic congestive heart failure and Cheyne-Stokes respirations or periodic breathing. [62][63][64][65][66][67][68][69][70][71][72][73] Whether it might also have application during NIV in patients with acute respiratory failure has not been studied, to my knowledge.…”