Efectos de la presión positiva continua nasal (CPAPn) sobre la función pulmonar en pacientes con síndrome de apnea obstructiva del sueño (SAOS)

Oliva, Rosa Vázquez; Gómez, Sílvia; Gil, F. Capote; Armengol, Marta; Bernal, C. Carmona; Gómez, J. Castillo

doi:10.1016/s0300-2896(15)30982-0

Cited by 4 publications

(5 citation statements)

References 20 publications

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“…Weight loss involves an improvement in "compliance" of the rib cage and ventilation/perfusion ratio. 13 Both factors may justify, at least in part, the results obtained.…”

Section: Discussionmentioning

confidence: 97%

“…[22][23][24] Treatment with CPAP may also counteract autopositive end-expiratory pressure (auto-PEEP) in hyperinsuflated COPD patients. 13,25 It may be possible that during sleep, in particular during rapid eye movement (REM) sleep stages in which breathing is irregular, auto-PEEP increases. 20 Treatment with CPAP may contribute to counteract this effect in patients with overlap syndrome by decreasing respiratory muscle load, oxygen consumption, and production of CO 2 .…”

Section: Discussionmentioning

confidence: 99%

“…20 Treatment with CPAP may contribute to counteract this effect in patients with overlap syndrome by decreasing respiratory muscle load, oxygen consumption, and production of CO 2 . 13 Another effect of CPAP in COPD patients is an improvement in ventilation/ perfusion ratio, which has no adverse effects on lung mechanics or hemodynamic parameters. 26 The effect of CPAP therapy on respiratory muscles may justify the improvement found in lung function studies.…”

Section: Discussionmentioning

confidence: 99%

“…These changes were more apparent in hyperinsuflated patients. On the other hand, in patients with overlap syndrome, Vázquez et al 13 reported that CPAP application caused an increase in maximal inspiratory pressure and FVC. These authors, however, did not find significant changes in the degree of bronchial obstruction, and for this reason, they attributed their findings to an improvement in the function of respiratory muscles.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, the long-term effects of CPAP on lung function and pulmonary hemodynamics have not been systematically investigated. In the majority of follow-up studies of the effects of CPAP therapy for sleep disordered breathing, [8][9][10][11][12][13][14] patients with intrinsic lung disease have not been distinguished as a separate subgroup, so the benefits of nasal CPAP treatment in patients with overlap syndrome remain unknown.…”

Section: Patientsmentioning

confidence: 99%

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Long-Term Effects of Treatment with Nasal Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

et al. 2002

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We assessed the effects of chronic nasal continuous positive airway pressure (CPAP) therapy on lung function in a series of unselected patients with overlap syndrome, and we determined whether there were differences in the response induced by CPAP between hypercapnic (PaCO2 > or =45 mm Hg) and eucapnic patients with overlap syndrome. The study population included 55 unselected patients (48 men, mean age of 58.5 +/- 10.5 years) with a concurrent diagnosis of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea-hypopnea syndrome (OSAHS) who had been referred to the Department of Pulmonology of our hospital over 2 consecutive years and in whom work-up studies resulted in the prescription of nasal CPAP therapy. An apnea-hypopnea index (AHI) greater than or equal to 10 in the cardiorespiratory polygraphy was required for the diagnosis of OSAHS. A forced expiratory volume in one second (FEV1) less than 80% and FEV1-forced vital capacity (FVC) ratio less than 70% of the reference values were required for the diagnosis of COPD. Control lung function studies and arterial blood gas measurements were performed at 6 and 18 months of CPAP therapy. These patients with overlap syndrome accounted for 28.5% of all patients with OSAHS treated with CPAP during the study period. The mean AHI was 37.3 +/- 26.1 and the mean CPAP level 7.3 +/- 1.3 cm H2O. Thirty-three patients were hypercapnic (PaCO2 > or = 45 mm Hg) and 22 eucapnic. The hypercapnic group had higher AHI value (44.3 +/- 26.9) than the eucapnic group (28.6 +/- 21.9) (P < 0.05). After 6 months of CPAP therapy, there were statistically significant increases in PaO2, FEV1, and FVC, accompanied by significant decreases in PaCO2, serum bicarbonate levels, and alveolar-arterial oxygen difference. Response of overlap syndrome patients to CPAP therapy was superior in the hypercapnic group, particularly in relation to improvement of arterial blood gases. However, statistically significant differences in all parameters for the comparison between 6 and 18 months were not recorded.

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“…Weight loss involves an improvement in "compliance" of the rib cage and ventilation/perfusion ratio. 13 Both factors may justify, at least in part, the results obtained.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

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Long-Term Effects of Treatment with Nasal Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

et al. 2002

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Lack of Benefit of Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

O’Brien

Whitman

2005

Lung

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Obstructive sleep apnea (OSA) has been shown to be an inflammatory stimulus and may potentially result in a deterioration in the respiratory status of patients with coexistent chronic obstructive pulmonary disease (COPD) (overlap syndrome). We hypothesized that with treatment of OSA, there would be an improvement in coexistent COPD in overlap patients. We also sought to characterize overlap patients by comparing them with patients with either OSA or COPD alone. We performed a retrospective study of patients who attended a university-affiliated Veterans Affairs hospital. Demographic and clinical data were obtained from the medical charts and pharmacy records for the preceding two years and for the two years following the initiation of continuous positive airway pressure (CPAP) therapy. Overlap patients had moderately severe sleep apnea (AHI 28.6 +/- 4.2) and moderately severe COPD (FEV1= 1.94 +/- 0.10 L). The prevalence of overlap syndrome in COPD patients was 11.9%, and 41% in OSA patients. Overlap patients who were compliant with CPAP therapy experienced a greater decrease in FEV1, percent predicted FEV1, percent decrease in FEV1, FVC, percent predicted FVC, and percent decrease in FVC when compared with noncompliant patients. A very strong correlation was found between the average hours of CPAP use per day and the percent decrease in FEV1 (r = 0.69, p = 0.003). There was a similar strong correlation for the decrease in FEV1 and percent predicted FEV1. OSA is common in COPD patients; similarly, COPD is common in OSA patients. Treatment of OSA with CPAP therapy in patients with overlap syndrome may not lead to an improvement in the coexistent COPD.

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Estudio comparativo de pacientes con enfermedad pulmonar obstructiva crónica con y sin síndrome de apneas obstructivas durante el sueño

Calderón-Osuna

Bernal

Gordillo

et al. 1999

Archivos de Bronconeumología

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Efectos de la presión positiva continua nasal (CPAPn) sobre la función pulmonar en pacientes con síndrome de apnea obstructiva del sueño (SAOS)

Cited by 4 publications

References 20 publications

Long-Term Effects of Treatment with Nasal Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

Long-Term Effects of Treatment with Nasal Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

Lack of Benefit of Continuous Positive Airway Pressure on Lung Function in Patients with Overlap Syndrome

Estudio comparativo de pacientes con enfermedad pulmonar obstructiva crónica con y sin síndrome de apneas obstructivas durante el sueño

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