Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 2 de 2
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Sleep Breath ; 19(4): 1285-92, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25813356

RESUMO

PURPOSE: Opioid treatment of non-malignant chronic pain can result in hypoxemia, hypercarbia, and central sleep apnea. The aim of this study was to determine the initial efficacy of auto servo-ventilation (ASV) and after 3 months of home use. METHODS: This prospective multicenter interventional study recruited chronic pain patients prescribed ≥100 morphine equivalents for at least 4 months. PARTICIPANTS: Following full-night polysomnography (PSG) to confirm the presence of sleep-disordered breathing, patients were randomized to three additional full-night-attended PSGs with continuous positive airway pressure (CPAP), ASV, and servo-ventilation with an initial mandatory pressure support of 6 cm H2O (ASV manual PSmin 6). Following the PSGs, patients were sent home with EncoreAnywhere and ASV with or without mandatory pressure support. RESULTS: Based on the initial PSG studies, CPAP improved but did not normalize the apnea-hypopnea index (AHI), central apnea index (CAI), or hypopnea index (HI), as all remained elevated. Clinically significant reductions were noted after just one night of ASV and ASV manual (PSmin 6). After 3 months of ASV home use, the AHI, CAI, and obstructive apnea index (OAI) were significantly reduced when compared to baseline diagnostic levels and even when compared to respiratory disturbance indices with CPAP treatment. CONCLUSIONS: Initial and home use of ASV for 3 months resulted in significantly lower AHI, CAI, and OAI. This reduction attests to the efficacy of ASV treatment in chronic pain patients on high doses of opioids.


Assuntos
Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Serviços Hospitalares de Assistência Domiciliar , Respiração com Pressão Positiva/métodos , Apneia do Sono Tipo Central/induzido quimicamente , Apneia do Sono Tipo Central/terapia , Adulto , Idoso , Analgésicos Opioides/uso terapêutico , Dor Crônica/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/efeitos dos fármacos , Respiração com Pressão Positiva/instrumentação , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
2.
Sleep ; 34(8): 1083-92, 2011 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-21804670

RESUMO

STUDY OBJECTIVES: (1) To determine the efficacy of automatically adjusted positive airway pressure (APAP) with a comfort feature (A-Flex) at reducing apneas and hypopneas in participants with moderate to severe OSA. (2) To determine the relative difference between A-Flex, continuous positive airway pressure (CPAP), and APAP-derived optimal pressure for CPAP (CPAP(APAP)) on adherence to treatment. (3) To determine the relative difference between APAP with A-Flex, CPAP, and CPAP(APAP) on long-term change in functional outcomes. DESIGN: Randomized, double-blinded, 3-arm, multicenter trial. SETTING: University and Veterans Affairs medical centers. PATIENTS OR PARTICIPANTS: 168 participants were randomized, and 140 completed the 180-day study. INTERVENTIONS: (1) A-Flex; (2) CPAP; (3) APAP for 14 days and then switched to CPAP at a fixed pressure. MEASUREMENTS AND RESULTS: Apnea-hypopnea indices, average and minimum oxygen saturation, time spent < 90% were significantly poorer for A-Flex vs. CPAP at the initiation of study treatment; with the exception of minimum oxygen saturation, these differences were absent at 180 days. A-Flex had lower average leak values at both 3 and 6 months. There were no significant differences between groups in major efficacy, adherence, and outcome (subjective sleepiness, objective vigilance, blood pressure, quality of life) measures. No differences between groups in attitudes toward use were observed at 3 or 6 months; participant ratings for CPAP were significantly higher than A-Flex on treatment satisfaction and benefit, but not different for sleep quality and mask comfort. CONCLUSIONS: We found that A-Flex shows equivalency, but non-superiority (except for average leak values), in efficacy, adherence, and functional outcomes compared to CPAP after either 3 or 6 months. CLINICAL TRIAL REGISTRY: Positive Pressure Treatment of Obstructive Sleep Apnea, http://www.clinicaltrials.gov, NCT00636181.


Assuntos
Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Cooperação do Paciente/estatística & dados numéricos , Apneia Obstrutiva do Sono/terapia , Adulto , Idoso , Pressão Positiva Contínua nas Vias Aéreas/métodos , Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos , Método Duplo-Cego , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia/métodos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...