Chest
Clinical InvestigationsSleep & BreathingComparison of Oxygen Therapy With Nasal Continuous Positive Airway Pressure on Cheyne-Stokes Respiration During Sleep in Congestive Heart Failure
Section snippets
Patient Selection
Twenty-five consecutive stable patients with severe (NYHA class IV) CHF were studied. All patients were clinically stable for at least 4 weeks prior to the study, with no change in their medications for a 2-week period (17 ± 4 days) prior to the start of the study as well as during the entire study period. The protocol was approved by our institutional review board, and informed consent was obtained from each patient prior to the study. Patients were excluded from the study if they (1) had an
Patient Characteristics
Twenty-five patients (24 men and 1 woman) with a mean (± SD) age of 56 ± 9 years and body mass index (BMI) of 28 ± 1 kg/m2 were studied (Table 1). All patients were stable with NYHA class IV CHF and a mean LVEF of 17 ± 0.8%. Patients were maximized on their medications prior to the study, including the use of a continuous inotropic infusion of either dobutamine (n = 20) at 5 ± 0.3 μg/kg/min or milrinone (n = 5) at 0.4 ± 0.1 μg/kg/min through an indwelling central venous catheter. Baseline
Discussion
We studied a homogeneous group of stable patients with severe CHF who were awaiting heart transplantation. All were medically optimized prior to the study, with no change in their medical regimen for a 2-week period prior to the start of the study as well as during the entire study period. The present study has the following two significant findings: (1) that sleep-disordered breathing of the Cheyne-Stokes variety occurred in greater than half the patients (56%) who were stable with severe CHF;
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2016, Sleep MedicineCitation Excerpt :The positive effects of NOT were more obvious on nocturnal oximetry in patients with sleep apnea than antiapnea effects. Data were available for mean nocturnal arterial oxyhemoglobin saturation (SaO2) in eight of the reviewed studies and were on average 94.3% ± 1% at baseline versus 97.3% ± 1% with NOT [26,29–31,33,35,37,38]. Those results showed that NOT may increase total body oxygen storage [43].
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2016, Sleep Medicine ClinicsCitation Excerpt :Preliminary data have been promising83,100,111–119 and long-term outcome data are pending (NCT01128816 and NCT00733343). Supplemental inspired oxygen therapy maintains arterial oxygenation during CSR, but can also resolve CSR effectively in many patients.117,120–122 Relief of hypoxemia is expected to reduce chemosensitivity (“G” in Equation 1) and thereby reduce loop gain.105
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