1994
DOI: 10.1164/ajrccm.150.2.8049832
|View full text |Cite
|
Sign up to set email alerts
|

Flow limitation as a noninvasive assessment of residual upper-airway resistance during continuous positive airway pressure therapy of obstructive sleep apnea.

Abstract: Many patients with obstructive sleep apnea syndrome (OSAS), despite therapy with nasal continuous positive airway pressure (CPAP), have persisting daytime somnolence that may be due to a persistently elevated upper-airway resistance associated with electroencephalographic (EEG) arousals. We tested the hypothesis that elevated upper-airway resistance can be inferred from the contour of the inspiratory flow tracing obtained from a conventional CPAP circuit. This may provide a noninvasive method for determining o… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
3
1
1

Citation Types

4
155
0
9

Year Published

1996
1996
2012
2012

Publication Types

Select...
5
3

Relationship

0
8

Authors

Journals

citations
Cited by 229 publications
(168 citation statements)
references
References 18 publications
4
155
0
9
Order By: Relevance
“…It should also be borne in mind that some hysteresis exists in the pressure required to suppress respiratory events. This has been demonstrated with inspiratory flow limitation, which requires about 2 cmH 2 O more to be eliminated during upwards titration of CPAP than the pressure at which it disappears during downwards titration [12].…”
Section: P Lévy J-l Pepinmentioning
confidence: 98%
See 2 more Smart Citations
“…It should also be borne in mind that some hysteresis exists in the pressure required to suppress respiratory events. This has been demonstrated with inspiratory flow limitation, which requires about 2 cmH 2 O more to be eliminated during upwards titration of CPAP than the pressure at which it disappears during downwards titration [12].…”
Section: P Lévy J-l Pepinmentioning
confidence: 98%
“…An additional approach that has been proposed is to use oesophageal pressure monitoring to titrate the level of CPAP to the pressure which minimizes intrathoracic pressure swings indicative of high resistance, thus correcting any elevated upper airway obstruction. A similar but noninvasive method is to use the inspiratory flow contour (flow limitation) to effect the CPAP titration [12]. Most, if not all the signals mentioned above are poorly standardized in terms of techniques of measurement and reference values.…”
Section: P Lévy J-l Pepinmentioning
confidence: 99%
See 1 more Smart Citation
“…Second, esophageal manometry was not used to monitor inspiratory effort and assess for the presence of IFL. We could nevertheless rely on the inspiratory flow contour to distinguish flow-limited from non-flow-limited breaths, because the inspiratory plateau remains a well-validated index of inspiratory airflow limitation (34,35) during natural sleep. Third, we recognized that arousal could confound the assessment of flow responses and designed the experimental protocol and analytic approaches to minimize this possibility.…”
Section: Limitationsmentioning
confidence: 99%
“…Some stop when there are no further arterial oxygen desaturations, some when there is no further snoring, and some, using a pneumotachometer to measure the shape of the inspiratory flow-time curve, also aim to minimize silent inspiratory airflow limitation. The latter has been shown [21] to indicate the presence of high upper airway resistance and large oesophageal pressure swings, which can lead to repetitive arousals in the absence of apnoeas and hypopnoeas [22]. The AutoSet ™ system detects and quantifies the degree of flattening of the inspiratory flow-time curve and sets the pressure accordingly [17,18].…”
Section: Pressure Requirementmentioning
confidence: 99%