Maxime Patout1,2, Frédéric Gagnadoux3, Claudio Rabec4, Wojciech Trzepizur3, Marjolaine Georges4, Christophe Perrin5, Renaud Tamisier6, Jean-Louis Pépin, Claudia Llontop7, Valerie Attali8,9, Frederic Goutorbe10, Sandrine Pontier-Marchandise11, Pierre Cervantes12, Vanessa Bironneau13,14, Adriana Portmann1,2, Jacqueline Delrieu14, Antoine Cuvelier1,2, Jean-François Muir1,2,14. 1. Service de Pneumologie, oncologie thoracique et Soins Intensifs Respiratoires, Rouen University Hospital, Rouen, France. 2. Normandie Univ, UNIRouen, EA3830-GRHV, Institute for Research and Innovation in Biomedicine (IRIB), Rouen, France. 3. Département de Pneumologie, Centre Hospitalier Universitaire d'Angers, Angers, France. 4. Pulmonary Department and Respiratory Critical Care Unit, University Hospital Dijon, Dijon, France. 5. Service de Pneumologie, Hôpital de Cannes, Cannes, France. 6. Pôle Thorax and Vaisseaux, Grenoble Alps University Hospital, Grenoble, France. 7. Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Assistance Publique Hôpitaux de Paris (APHP), Paris, France. 8. UMRS_1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, INSERM, Paris, France. 9. Service des Pathologies du Sommeil (Département 'R3S'), Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Assistance Publique Hôpitaux de Paris (APHP), Paris, France. 10. Pneumologie, Hôpital de Béziers, Béziers, France. 11. Pneumologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. 12. Service de Pneumologie Hôpitaux Privés de Metz, Hôpital Robert Schuman, Metz, France. 13. Pneumologie, Centre Hospitalier Universitaire de Poitiers, Poitiers, France. 14. ANTADIR, Paris, France.
Abstract
BACKGROUND AND OBJECTIVE:Average volume-assured pressure support-automated expiratory positive airway pressure (AVAPS-AE) combines an automated positive expiratory pressure to maintain upper airway patency to an automated pressure support with a targeted tidal volume. The aim of this study was to compare the effects of 2-month AVAPS-AE ventilation versus pressure support (ST) ventilation on objective sleep quality in stable patients with OHS. Secondary outcomes included arterial blood gases, health-related quality of life, daytime sleepiness, subjective sleep quality and compliance to NIV. METHODS: This is a prospective multicentric randomized controlled trial. Consecutive OHS patients included had daytime Pa CO2 >; 6 kPa, BMI ≥ 30 kg/m2 , clinical stability for more than 2 weeks and were naive from home NIV. PSG were analysed centrally by two independent experts. Primary endpoint was sleep quality improvement at 2 months. RESULTS: Among 69 trial patients, 60 patients had successful NIV setup. Baseline and follow-up PSG were available for 26 patients randomized in the ST group and 30 in the AVAPS-AE group. At baseline, Pa CO2 was 6.94 ± 0.71 kPa in the ST group and 6.61 ± 0.71 in the AVAPS-AE group (P = 0.032). No significant between-group difference was observed for objective sleep quality indices. Improvement in Pa CO2 was similar between groups with a mean reduction of -0.87 kPa (95% CI: -1.12 to -0.46) in the ST group versus -0.87 kPa (95% CI: -1.14 to -0.50) in the AVAPS-AE group (P = 0.984). Mean NIV use was 6.2 h per night in both groups (P = 0.93). NIV setup duration was shorter in the AVAPS-AE group (P = 0.012). CONCLUSION:AVAPS-AE and ST ventilation for 2 months had similar impact on sleep quality and gas exchange.
RCT Entities:
BACKGROUND AND OBJECTIVE: Average volume-assured pressure support-automated expiratory positive airway pressure (AVAPS-AE) combines an automated positive expiratory pressure to maintain upper airway patency to an automated pressure support with a targeted tidal volume. The aim of this study was to compare the effects of 2-month AVAPS-AE ventilation versus pressure support (ST) ventilation on objective sleep quality in stable patients with OHS. Secondary outcomes included arterial blood gases, health-related quality of life, daytime sleepiness, subjective sleep quality and compliance to NIV. METHODS: This is a prospective multicentric randomized controlled trial. Consecutive OHSpatients included had daytime PaCO2 > 6 kPa, BMI ≥ 30 kg/m2 , clinical stability for more than 2 weeks and were naive from home NIV. PSG were analysed centrally by two independent experts. Primary endpoint was sleep quality improvement at 2 months. RESULTS: Among 69 trial patients, 60 patients had successful NIV setup. Baseline and follow-up PSG were available for 26 patients randomized in the ST group and 30 in the AVAPS-AE group. At baseline, PaCO2 was 6.94 ± 0.71 kPa in the ST group and 6.61 ± 0.71 in the AVAPS-AE group (P = 0.032). No significant between-group difference was observed for objective sleep quality indices. Improvement in PaCO2 was similar between groups with a mean reduction of -0.87 kPa (95% CI: -1.12 to -0.46) in the ST group versus -0.87 kPa (95% CI: -1.14 to -0.50) in the AVAPS-AE group (P = 0.984). Mean NIV use was 6.2 h per night in both groups (P = 0.93). NIV setup duration was shorter in the AVAPS-AE group (P = 0.012). CONCLUSION:AVAPS-AE and ST ventilation for 2 months had similar impact on sleep quality and gas exchange.
Authors: John Mario Levri; Naomitsu Watanabe; Victor T Peng; Steven M Scharf; Montserrat Diaz-Abad Journal: Sleep Breath Date: 2021-05-07 Impact factor: 2.816
Authors: Karin G Johnson; Vida Rastegar; Nicholas Scuderi; Douglas C Johnson; Paul Visintainer Journal: J Clin Sleep Med Date: 2022-07-01 Impact factor: 4.324
Authors: Killen H Briones-Claudett; Mónica H Briones-Claudett; Mariuxi Del Pilar Cabrera Baños; Killen H Briones Zamora; Diana C Briones Marquez; Luc J I Zimmermann; Antonio W D Gavilanes; Michelle Grunauer Journal: Crit Care Res Pract Date: 2022-08-03