Adaptive servo-ventilation as treatment of persistent central sleep apnea in post-acute ischemic stroke patients

被引：29
作者：
Brill, Anne-Kathrin [1 ,2 ]
Roesti, Regula [1 ,2 ]
Hefti, Jacqueline Pichler [1 ,2 ]
Bassetti, Claudio [2 ,3 ]
Gugger, Matthias [1 ,2 ]
Ott, Sebastian R. [1 ,2 ]
机构：
[1] Univ Hosp Bern, Inselspital, Dept Pulm Med, CH-3010 Bern, Switzerland
[2] Univ Bern, CH-3010 Bern, Switzerland
[3] Univ Hosp Bern, Inselspital, Dept Neurol, CH-3010 Bern, Switzerland
来源：
SLEEP MEDICINE | 2014年 / 15卷 / 11期
关键词：
Sleep disordered breathing; Cerebrovascular insult; Epworth Sleepiness Scale; Neurologic disorders; Stroke distribution; Continuous positive airway pressure; CHEYNE-STOKES RESPIRATION; POSITIVE AIRWAY PRESSURE; LEFT-VENTRICULAR DYSFUNCTION; DAYTIME SLEEPINESS; BREATHING DISORDERS; PREVALENCE; SERVOVENTILATION; MORTALITY; TIME;
D O I：
10.1016/j.sleep.2014.06.013
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
Background: Adaptive servo-ventilation (ASV) is a well-established treatment of central sleep apnea (CSA) related to congestive heart failure (CHF). Few studies have evaluated the effectiveness and adherence in patients with CSA of other etiologies, and even less is known about treatment of CSA in patients of post ischemic stroke. Methods: A single-centre retrospective analysis of ASV treatment for CSA in post-acute ischemic stroke patients without concomitant CHF was performed. Demographics, clinical data, sleep studies, ventilator settings, and adherence data were evaluated. Results: Out of 154 patients on ASV, 15 patients had CSA related to ischemic stroke and were started on ASV a median of 11 months after the acute cerebrovascular event. Thirteen out of the 15 patients were initially treated with continuous positive airway pressure (11/15) and bilevel positive airway pressure (2/15) therapy with unsatisfactory control of CSA. ASV significantly improved AHI (46.7 +/- 24.3 vs 8.5 +/- 12/h, P = 0.001) and reduced ESS (8.7 +/- 5.7 vs 5.6 +/- 2.5, P = 0.08) with a mean nightly use of ASV of 5.4 +/- 2.4 h at 3 months after the initiation of treatment. Results were maintained at 6 months. Conclusion: ASV was well tolerated and clinically effective in this group of patients with persistent CSA after ischemic stroke. (C) 2014 Elsevier B.V. All rights reserved.
引用
收藏
页码：1309 / 1313
页数：5
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