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[Positive pressure ventilation in Cheyne-Stokes respiration]
B Schönhofer1, T Barchfeld, S Suchi
1Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, Schmallenberg-Grafschaft, Germany. Bernd.Schoenhofer@t-online.de
Pneumologie (Stuttgart, Germany)
|June 29, 2002
Summary
Cheyne-Stokes respiration (CSR) in heart failure patients responded well to positive pressure ventilation. Bilevel positive airway pressure in controlled mode (BiPAP T) offered the best quality of life, though less frequently used.
Area of Science:
- Cardiology
- Pulmonology
- Sleep Medicine
Background:
- Cheyne-Stokes respiration (CSR) is a common complication in patients with chronic left ventricular failure.
- CSR is associated with a poorer prognosis in heart failure patients.
- Continuous positive airway pressure (CPAP) has shown to improve survival rates in these patients.
Purpose of the Study:
- To evaluate the effectiveness of different positive pressure ventilation modes in patients with CSR.
- To compare the response rates and quality of life across various ventilation settings.
Main Methods:
- A retrospective study analyzing data from 1995-1999.
- Inclusion criteria: CSR with a respiratory disturbance index > 10/h, with >50% central/mixed events.
- Four-week interventions with CPAP, BiPAP S/ST (spontaneous mode), and BiPAP T (controlled mode) were administered to 41 male patients.
Main Results:
- Overall response rates: CPAP (31.7%), BiPAP S/ST (22.0%), BiPAP T (29.3%).
- 7.1% of patients rejected long-term positive pressure ventilation.
- The majority of patients responded to CPAP and BiPAP S/ST.
- BiPAP T demonstrated the best quality of life, but was used by only 29% of the population.
Conclusions:
- Positive pressure ventilation, including CPAP and BiPAP S/ST, is effective for managing CSR in heart failure.
- BiPAP T may offer superior quality of life but requires further investigation regarding adherence and optimal patient selection.