Acute effect of nasal continuous positive air pressure on the ventilatory control of patients with obstructive sleep apnea

Acute effect of nasal continuous positive air pressure on the ventilatory control of patients with obstructive sleep apnea

Autor Moura, SMT Google Scholar
Bittencourt, L. R. Google Scholar
Bagnato, M. C. Google Scholar
Lucas, SR Google Scholar
Tufik, S. Google Scholar
Nery, L. E. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo Background: Sleep fragmentation can decrease the awake ventilatory control. Since patients with obstructive sleep apnea (OSA) patients exhibit sleep fragmentation linked to respiratory events, their ventilatory control could be impaired. However, most of these patients are also obese, which could conversely increase the ventilatory control. the effect of nasal continuous positive airway pressure (CPAP) on the awake ventilatory control in normocapnic OSA patients is unclear. Objectives: To study the acute effect of nasal CPAP on the awake ventilatory control in normocapnic OSA patients. Methods: 12 normocapnic OSA patients, with an apnea/hypopnea index (AHI) >15 with moderate obesity (body mass index: 33.5 kg/m(2)) and normal pulmonary function tests were submitted to two polysomnography studies (diagnostic and for CPAP titration). Before and after 3 consecutive nights of nasal CPAP we analyzed the hypersomnia score and the ventilatory and the mouth occlusion pressure (P.(1)) responses at rest (breathing room air and a mixture of 8% CO2 + 40% O-2) Results: the respiratory drive of OSA patients as evaluated by P.(1) was in the range of the controls of our laboratory. After nasal CPAP, a significant decrease in AHI (mean: 51.9-9.4/h) and arousal (mean: 88.7-43/h) occurred, as well as improve ment in nocturnal oxyhemoglobin. There was a marginal increase in DeltaV(E)/DeltaP(ET)CO(2) (mean: 1.41-1.87 liters/min/mm Hg, p = 0.09) and a significant rise in P .(1)/DeltaP(ET)CO(2) (mean: 0.29-0.43 cm H2O/mm Hg), a better indicator of ventilatory drive. Conclusions: Normocapnic OSA patients increased their awake ventilatory drive response to a hypercapnic and hyperoxic mixture with the use of 3 consecutive nights of nasal CPAP. Copyright (C) 2001 S. Karger AG, Basel.
Palavra-chave obstructive sleep apnea
ventilatory drive
hypersomnia
nasal continuous positive air pressure
obesity
Idioma Inglês
Data de publicação 2001-05-01
Publicado em Respiration. Basel: Karger, v. 68, n. 3, p. 243-249, 2001.
ISSN 0025-7931 (Sherpa/Romeo, fator de impacto)
Publicador Karger
Extensão 243-249
Fonte http://dx.doi.org/10.1159/000050505
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000169289500004
Endereço permanente http://repositorio.unifesp.br/handle/11600/26548

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