固定CPAP在10cmH2O可能取代手动定位中度至重度OSA患者:初步随机对照试验
Wang Lu1, Yan Chen1, Qishan Wei1
1State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, China.
概括
在10cmH2O的持续正气道压力 (CPAP) 有效地治疗OSA患者,无需手动定位. 这种方法简化了治疗,并保持了患者的遵守,类似于标准方法.
科学领域:
- 呼吸系统医学 呼吸系统医学
- 睡眠医学 睡眠医学
- 肺部病理学 肺部病理学
背景情况:
- 持续正气道压力 (CPAP) 是阻塞性睡眠呼吸暂停 (OSA) 的标准治疗方法.
- 患者对CPAP治疗的遵从性可能会受到定位方法的影响.
- 自动定位压力往往高于手动定位,但合规性仍然相似.
研究的目的:
- 确定可容忍的最高CPAP压力,不增加健康志愿者和OSA患者的呼吸力度.
- 通过确定固定的有效压力来简化CPAP压力定位.
- 评估是否可以在没有定位的情况下使用10cmH2O的固定CPAP压力.
主要方法:
- 第1部分:在健康受试者和OSA患者的各种CPAP水平下,评估了呼吸储备体积,隔膜EMG和呼吸肌EMG. 通过问卷评估呼吸困难.
- 第2部分:在25名OSA患者中进行了一项随机交叉双盲试验,比较固定10cmH2OCPAP与手动定位压力在两晚内.
主要成果:
- 隔膜EMG显示CPAP水平在10cmH2O以上变化很小,而呼吸肌活动在12cmH2O以上增加.
- 在CPAP≤10cmH2O时,主观呼吸困难没有显著差异.
- 睡眠结构,呼吸暂停-呼吸暂停指数 (AHI) 和患者偏好在10cmH2OCPAP和定位压力之间是可比的.
结论:
- 固定CPAP压力为10cmH2O对于治疗中度至重度的OSA是有效的.
- 在大多数OSA患者中,在10cmH2O的初始CPAP治疗可以在不需要压力定位的情况下实施.
- 这种简化方法可以改善OSA患者的治疗可及性和治疗坚持.
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