Effectiveness of Adaptive Servo Ventilation in the treatment of hypocapnic central sleep apnea of various etiologies

Carnevale, Claudio; Georges, Marjolaine; Rabec, Claudio; Tamisier, Renaud; Lévy, Patrick; Pépin, Jean‐Louis

doi:10.1016/j.sleep.2011.07.008

Cited by 27 publications

(22 citation statements)

References 37 publications

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“…It is also used in the treatment of other forms of CSA, such as idiopathic CSA, CPAP-emerged CSA and opioid-induced CSA [53,54] . ASV devices automatically provide altering pressure support for each inspiration, ranging from a pre-set minimum level to a pre-set maximum level, to maintain moving target ventilation (determined based on volume or flow) determined by the patient's current breathing in addition to the back-up ventilation with variable respiratory rates (i.e., servo-control of ventilation) ( Figure 6).…”

Section: Asvmentioning

confidence: 99%

Positive airway pressure therapy for heart failure

Kato

Suda

Kasai

2014

WJC

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Section: Asvmentioning

confidence: 99%

Positive airway pressure therapy for heart failure

Kato

Suda

Kasai

2014

WJC

View full text Add to dashboard Cite

“…However, two thirds of the patients in this study were effectively managed with standard CPAP or BPAP [64]. Another retrospective study compared central sleep apnea in patients with CHF versus non-CHF patients [65]. This study showed that ASV was highly efficacious in eliminating events for both groups of patients [65].…”

Section: Asv For Idiopathic and Opioid-induced Central Sleep Apneamentioning

confidence: 82%

“…Another retrospective study compared central sleep apnea in patients with CHF versus non-CHF patients [65]. This study showed that ASV was highly efficacious in eliminating events for both groups of patients [65]. These findings suggest that ASV may apply to other populations with central sleep-disordered breathing that is not due to chronic respiratory failure.…”

Section: Asv For Idiopathic and Opioid-induced Central Sleep Apneamentioning

confidence: 91%

Advanced Positive Airway Pressure Modalities

Bierer¹,

Ryden

Aysola³

2015

Curr Sleep Medicine Rep

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Auto-adjusting positive airway pressure (PAP) devices are increasingly becoming the first line treatment for obstructive sleep apnea (OSA). More complex sleepdisordered breathing such as Cheyne-Stokes respirations and central sleep apnea related to heart failure as well as complex sleep-disordered breathing related to chronic hypoventilation syndromes may require the use of advanced positive airway pressure modalities such as automated servo ventilation (ASV) and volume targeted pressure limited ventilation. Identifying patients with complex sleep-disordered breathing that will benefit from treatment with advanced modalities remains an area of active investigation. A recent and surprising development found ASV to be associated with an increased risk of sudden cardiac death when used to treat central sleep apnea in patients with symptomatic systolic heart failure and an ejection fraction less than 45 %. The optimal treatment of central sleep apnea in heart failure and the role of ASV are currently in question. The following chapter is intended to provide the clinician with a description of newer PAP modalities; a review of evidence supported indications for use as well as provide a framework for managing patients with advanced positive airway pressure therapy.

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“…One study 5 compared therapeutic to sub-therapeutic ASV, 10 studies 2,6-14 compared ASV treatment to standard care, 7 studies [15][16][17][18][19][20][21] compared ASV treatment to baseline, 4 studies 22-25 compared ASV to CPAP, 3 studies 26-28 compared it to BPAP-ST, 1 study 29 compared ASV to either CPAP or BPAP (these 2 treatment results were combined), and 3 study compared ASV to oxygen.…”

Section: Discussionmentioning

confidence: 99%

Updated Adaptive Servo-Ventilation Recommendations for the 2012 AASM Guideline: “The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses”

Bista

et al. 2016

Journal of Clinical Sleep Medicine

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An update of the 2012 systematic review and meta-analyses were performed and a modified-GRADE approach was used to update the recommendation for the use of adaptive servo-ventilation (ASV) for the treatment of central sleep apnea syndrome (CSAS) related to congestive heart failure (CHF). Metaanalyses demonstrated an improvement in LVEF and a normalization of AHI in all patients. Analyses also demonstrated an increased risk of cardiac mortality in patients with an LVEF of ≤ 45% and moderate or severe CSA predominant sleep-disordered breathing. These data support a Standard level recommendation against the use of ASV to treat CHF-associated CSAS in patients with an LVEF of ≤ 45% and moderate or severe CSAS, and an Option level recommendation for the use of ASV in the treatment CHF-associated CSAS in patients with an LVEF > 45% or mild CHF-related CSAS. The application of these recommendations is limited to the target patient populations; the ultimate judgment regarding propriety of any specific care must be made by the clinician.

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Effectiveness of Adaptive Servo Ventilation in the treatment of hypocapnic central sleep apnea of various etiologies

Cited by 27 publications

References 37 publications

Positive airway pressure therapy for heart failure

Positive airway pressure therapy for heart failure

Advanced Positive Airway Pressure Modalities

Updated Adaptive Servo-Ventilation Recommendations for the 2012 AASM Guideline: “The Treatment of Central Sleep Apnea Syndromes in Adults: Practice Parameters with an Evidence-Based Literature Review and Meta-Analyses”

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