AVAPS-AE vs. ST mode: A randomised controlled trial in patients with obesity hypoventilation syndrome

Patout, Maxime; Gagnadoux, Frédéric; Rabec, Claudio; Trzépizur, Wojciech; Georges, Marjolaine; Perrin, Christophe; Tamisier, Renaud; Llontop, Claudia; Goutorbe, F.; Gounane, C.; Pontier-Marchandise, S.; Cervantes, P.; Bironneau, Vanessa; Portmann, Adriana; Delrieu, Jacqueline; Muir, Jean-François; Cuvelier, A.

doi:10.1183/13993003.congress-2018.pa1674

Cited by 2 publications

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“…This offers potential advantages of maintaining upper airway patency and maintaining the patient on the compliant part of the pressure-volume curve. These newer modes have recently been shown to be safe and effective in treating OHS over the medium term (3 months) compared to fixed bi-level PAP [76]. A potential benefit of these modes is that it may facilitate outpatient PAP setup with a device achieving titration in the home environment with subsequent reduction in healthcare utilisation of an in-patient or in-laboratory PAP titration study [77].…”

Section: Pap Treatment: Volume Targeted Pressure Supportmentioning

confidence: 99%

Obesity hypoventilation syndrome

et al. 2019

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Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥30 kg·m−2), daytime hypercapnia (arterial carbon dioxide tension ≥45 mmHg) and sleep disordered breathing, after ruling out other disorders that may cause alveolar hypoventilation. OHS prevalence has been estimated to be ∼0.4% of the adult population. OHS is typically diagnosed during an episode of acute-on-chronic hypercapnic respiratory failure or when symptoms lead to pulmonary or sleep consultation in stable conditions. The diagnosis is firmly established after arterial blood gases and a sleep study. The presence of daytime hypercapnia is explained by several co-existing mechanisms such as obesity-related changes in the respiratory system, alterations in respiratory drive and breathing abnormalities during sleep. The most frequent comorbidities are metabolic and cardiovascular, mainly heart failure, coronary disease and pulmonary hypertension. Both continuous positive airway pressure (CPAP) and noninvasive ventilation (NIV) improve clinical symptoms, quality of life, gas exchange, and sleep disordered breathing. CPAP is considered the first-line treatment modality for OHS phenotype with concomitant severe obstructive sleep apnoea, whereas NIV is preferred in the minority of OHS patients with hypoventilation during sleep with no or milder forms of obstructive sleep apnoea (approximately <30% of OHS patients). Acute-on-chronic hypercapnic respiratory failure is habitually treated with NIV. Appropriate management of comorbidities including medications and rehabilitation programmes are key issues for improving prognosis.

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Section: Pap Treatment: Volume Targeted Pressure Supportmentioning

confidence: 99%

Obesity hypoventilation syndrome

et al. 2019

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“…Studies comparing the effectiveness of NIMV's BPAP S/T and AVAPS modes in the treatment of obesity hypoventilation and type 2 respiratory failure are available in the literature . As far as known, the first study comparing the effects of NIMV on IOP and CCT is this study.…”

Section: Discussionmentioning

confidence: 99%

The effects of non‐invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure

Aytekin

Gülhan

Teberik

et al. 2019

Clinical Respiratory J

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Background Chronic obstructive pulmonary disease (COPD) is not fully reversible disease that is characterized by progressive restricting airflow. Non‐invasive mechanical ventilation (NIMV) treatment can be used in COPD patients who had type 2 respiratory failure. This study aimed to determine the effect of BPAP S/T and AVAPS modes on intraocular pressure (IOP), central corneal thickness (CCT) in 40 type 2 respiratory failure patients with COPD. Methods Forty patients with type 2 respiratory failure who were hospitalized between June and December 2018 with the diagnosis of COPD exacerbations were included to the study. Patients followed up without NIMV for 12 hours after the end of exacerbations treatments end. After IOP, visual acuity and CCT were measured in all patients at the same time (11.00 am), same NIMV treatment was applied to the patients for 4 hours (AVAPS‐BPAP S/T). Then the measurements were repeated. The effects of these NIMV modes on IOP were evaluated. Results After NIMV treatment, it was observed that the mean IOP increased statistically significantly (13.3 vs 12.3 mm Hg; P = 0.001). After treatment with NIMV, there was a decrease for CCT close to statistical significance (P = 0.057) Conclusion As a result; increased IOP and thinning of CCT after NIMV treatment has been shown. The type of NIMV and the level of inspiratory pressure needed in hypercapnic respiratory failure seem to affect IOP and it should be cautiously used to increase IOP.

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AVAPS-AE vs. ST mode: A randomised controlled trial in patients with obesity hypoventilation syndrome

Cited by 2 publications

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Obesity hypoventilation syndrome

Obesity hypoventilation syndrome

The effects of non‐invasive mechanic ventilator modes on intraocular pressure in COPD patients with hypercapnic respiratory failure

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