C-Flex® Technology: Effects on Breathing Parameters and Inspiratory Flow Limitation

Canisius, Sebastian; Kesper, Karl; Jerrentrup, Lukas; Ploch, T.; Vogelmeier, Claus; Penzel, Thomas; Jerrentrup, Andreas

doi:10.1159/000189210

Cited by 4 publications

(3 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, in a prospective randomized study with 24 patients, our group demonstrated that there is no statistically significant difference regarding the occurrence of flow limitations with C-Flex compared to CPAP [33]. We also demonstrated that higher C-Flex gains were associated with a decrease in expiratory time in favor of the inspiratory duty cycle, while there was no significant change in tidal volume.…”

Section: Introductionmentioning

confidence: 71%

“…The available data might suggest an increase in the inspiratory work of breathing for increasing C-Flex gains, since a higher inspiratory duty cycle and higher inspiratory-to-expiratory time ratio are needed to achieve the same inspiratory tidal volume [34]. Such a change was demonstrated in case of flow limitations, which were not seen in any C-Flex setting [33]. Changes in duty cycle are predominant, while increases in breathing rate are much less pronounced.…”

Section: Introductionmentioning

confidence: 99%

“…To answer the question as to how C-Flex affects the work of breathing, we reanalyzed the recorded data from our study published in this journal [33]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Work of Breathing in Fixed and Pressure Relief Continuous Positive Airway Pressure (C-Flex™): A post hoc Analysis

Jerrentrup

Canisius²,

Wilhelm³

et al. 2016

Respiration

Self Cite

View full text Add to dashboard Cite

Background: Expiratory pressure relief continuous positive airway pressure (pressure relief CPAP; C-Flex™) causes increases in inspiratory duty cycle and shortening of expiratory time. It has been suggested that these changes are caused by an increase in work of breathing. Objectives: We studied the effects of C-Flex on work of breathing and intrinsic positive end-expiratory pressure as compared to fixed CPAP. Methods: Work of breathing was analyzed in 24 patients with obstructive sleep apnea during treatment with fixed CPAP and C-Flex with 3 different pressure relief settings in a randomized order during rapid-eye-movement (REM) and non-REM sleep. Work of breathing was assessed on a breath-by-breath basis using a piezoelectric esophageal pressure catheter and a pneumotachograph for measuring airflow. Results: We found there was no increase in inspiratory work of breathing observed using C-Flex compared to fixed CPAP. Instead, we found a linear decrease in inspiratory work of breathing with increasing pressure relief, with a mean difference of 1.22 J/min between CPAP and maximum pressure release (C-Flex 3; 90% of the value with nasal CPAP); however, the decrease was not statistically significant. The decrease in inspiratory work of breathing associated with C-Flex has a significant inverse correlation with BMI. Conclusions: The C-Flex technology does not change work of breathing but shows a tendency towards a reduction of inspiratory work of breathing in patients with a lower BMI using higher C-Flex. The effect is probably caused by diminishing airway resistance generated by the positive end-expiratory pressure. Our findings may lead to additional fields of application of the C-Flex technology, such as chronic obstructive pulmonary disease or muscular dystrophy.

show abstract

Section: Introductionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%