Outcome Measures of Auto-titrating Average Volume-assured Pressure Support (AVAPS) as Rescue Therapy After CPAP Titration Failure in Patients With Obesity Hypoventilation Syndrome: Adherence and Sleep Quality
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Obesity Hypoventilation Syndrome (OHS)
- Sponsor
- Assiut University
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- To compare the initial diagnostic, and therapeutic sleep study parameters using either CPAP and (AVAPS-AE) titration study in patients with OHS.
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
It remains unclear whether CPAP therapy should be prescribed if significant hypoxemia persists during CPAP titration, despite optimization of upper airway obstructive events, if maximum CPAP pressure is reached.
The goal was to examine the effects of 6 months of home AVAPS therapy in patients with obesity hypoventilation syndrome as a potential option for patients who failed CPAP titration due to persistent hypoxemia.
Detailed Description
Obesity hypoventilation syndrome (OHS) is one of the leading indications of home non-invasive ventilation (NIV) initiation. In patients with OHS, NIV improves daytime vigilance, decreases PaCO2, improves sleep quality, and improves physical activity. Thus, the primary aim of this study was to evaluate the effects of 6-month noninvasive ventilation with average volume-assured pressure support (AVAPS-AE) ventilation on objective sleep quality and adherence to therapy in stable patients with OHS who failed CPAP titration.
Investigators
Doaa Magdy Eid
professor of pulmonary medecine
Assiut University
Eligibility Criteria
Inclusion Criteria
- •All Clinically stable OHS patients with
- •Body mass index of 30 kg/m2 ,
- •Daytime hypercapnia (PaCO2 \>45 mm Hg) who had failed to respond to CPAP therapy
- •had no other cause for their chronic respiratory failure and were naive to any PAP therapy.
Exclusion Criteria
- •Patients with evidence of acute respiratory failure (patients with worsening symptoms during the last 2 weeks before the screening visit, a breathing frequency of 30 breaths/ minute, or signs of respiratory infections)
- •Patients who had been intubated during the last 3 months
- •Patients who had received any other form of ventilatory support before hospital admission were also excluded from the study
Outcomes
Primary Outcomes
To compare the initial diagnostic, and therapeutic sleep study parameters using either CPAP and (AVAPS-AE) titration study in patients with OHS.
Time Frame: 1 week
polysomnographic parameter (apnea hypopnea index (events/hours)
Secondary Outcomes
- The effects of 6 month of home AVAPS- AE therapy on patient adherence and sleep quality in OHS patients who failed CPAP titration due to persistent hypoxemia.(at 1 ,3,6 months)