The role of high-frequency jet ventilation in the treatment of Cheyne–Stokes respiration in patients with chronic heart failure
Section snippets
Subjects
Successive patients with stable, medically treated chronic congestive heart failure were enrolled in the study at Renmin Hospital of Wuhan University between September, 2003 and May, 2004. All patients were diagnosed by cardiologists in combinations of history, clinical signs, echocardiography, chest X-ray, and in most cases by left heart catheter, and were evaluated to confirm that their conditions were stable and that they were receiving optimal therapy. Informed written consent was obtained
Results
Twenty-three patients with chronic heart failure meeting all inclusion and exclusion criteria were considered for this study. Twelve patients did not complete all studies, of which, six subjects withdrew after the first intervention night (nCPAP or BiPAP) because of the inconvenience of the procedure, four subjects were unable to tolerate the jetting airflow or jetting noise from the HFJV, and the other two cases could not fulfil all requirements of the protocol and withdrew in the middle of
Discussion
Cheyne–Stokes respiration reflects uncompensated instability of the feedback control of ventilation.Current concepts of the pathophysiology of leading to CSR-CSA is a fluctuation of PaCO2 below and above the apneic threshold [1]. CHF causes pulmonary congestion and therefore activates pulmonary J receptors which stimulate ventilation. When PaCO2 is periodically driven below threshold by intervening episodes of hyperventilation, central neural outflow to the respiratory muscles is temporarily
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Association between polymorphisms of the HSPB7 gene and Cheyne–Stokes respiration with central sleep apnea in patients with dilated cardiomyopathy and congestive heart failure
2016, International Journal of CardiologyCitation Excerpt :The protocol of this study was in accordance with the principles of the current version of the Declaration of Helsinki, and had been approved by the Medical Ethics Committee of the Medical School at Wuhan University. Patients were taken to the sleep laboratory and PSG was performed according to the standards of the ATS [19], which we previously described [20]. The variables were digitally recorded and analyzed on a multichannel sleep diagnostic system (Somnoscreen Plus Tele PSG, Somnomedics GmbH, Germany).
International classification of sleep disorders 2 and american academy of sleep medicine practice parameters for central sleep apnea
2014, Sleep Medicine ClinicsCitation Excerpt :However, BPAP seems to be better than CPAP. ASV seems to be equivalent to or possibly better than CPAP and BPAP-ST, particularly in patients with CSBP.38–40 Meta-analyses evaluating the effects of cardiac resynchronization therapy (CRT) in CSAS have shown improvement in LVEF by 8% (95% CI, 5%–12%) and AHI by 12 per hour (95% CI, 9–14).2
CPAP and BPAP titration
2010, Sleep Medicine ClinicsCitation Excerpt :According to the International Classification of Sleep Disorders, Second Edition28 (ICSD-II) CSA syndromes encompass primary CSA and CSA caused by Cheyne-Stokes breathing pattern (CSA/CSR), high-altitude periodic breathing, or drug or substance use such as opioids. Several case-control, randomized crossover, and randomized controlled trials have shown the effectiveness of CPAP in reducing CSA (particularly in CSA/CSR and primary CSA) as measured using the AHI, with some studies showing improvement in the left ventricular ejection fraction and daytime alertness as measured by the Epworth sleepiness scale (ESS).29–32 Therefore, performing a CPAP titration for CSA is reasonable to assess for effectiveness before switching to a different PAP device, such as BPAP in the spontaneous timed mode (BPAP-ST) or adaptive servoventilators.
Treatment of central sleep apnea syndrome of multifactorial origin by home ventilatory support
2007, Archivos de BronconeumologiaA 64-year old man who sustained many episodes of acute cardiogenic pulmonary edema successfully treated with Boussignac continuous positive airway pressure: A case report
2007, International Journal of CardiologyCitation Excerpt :It has been demonstrated that BCPAP can also be used in pre-hospital settings [6]. Although there are other methods of non-invasive ventilatory support in heart failure, as recently described in this journal, e.g. high-frequency jet ventilation and positive pressure support, mask CPAP is the simplest, safest and most commonly used technique to treat patients with acute cardiogenic edema [7,8]. In conclusion, our case underscores the feasibility and effectiveness of BCPAP in environments where support with mechanical ventilators is not possible.
Comparative Evaluation of Therapeutic Approaches to Central Sleep Apnea
2019, Advanced Biomedical Research