通过预测方程进行自动滴定和计算，以确定阻塞性睡眠呼吸暂停的治疗性持续气道正压通气。

Automatic titration and calculation by predictive equations for the determination of therapeutic continuous positive airway pressure for obstructive sleep apnea.

作者信息

Marrone Oreste, Salvaggio Adriana, Romano Salvatore, Insalaco Giuseppe

机构信息

Italian National Research Council, Institute of Biomedicine and Molecular Immunology, A. Monroy, Sleep Laboratory, Palermo, Italy.

出版信息

Chest. 2008 Mar;133(3):670-6. doi: 10.1378/chest.07-1372.

DOI:10.1378/chest.07-1372

PMID:18321902

Abstract

BACKGROUND

It is unknown to what extent therapeutic continuous positive airway pressure (CPAP) levels obtained by various methods for the treatment of obstructive sleep apnea syndrome (OSAS) differ. This study aimed to explore the relationships among pressures titrated by an automatic CPAP (APAP) device and those calculated using different predictive equations, and to compare different ranges of calculated pressures with pressure values titrated by APAP.

METHODS

In 140 OSAS patients, the 95th percentile pressure delivered by an APAP device (AutoSet T; ResMed; Sydney, NSW, Australia) during polysomnography, and pressures calculated by three equations (equation 1, Hoffstein and Miljetig [1994]; equation 2, Sériès et al [2000]; and equation 3, Stradling et al [2004]) were compared.

RESULTS

Titrated and calculated pressures were weakly correlated. Significant differences were found between the mean (+/- SD) pressures (11.1 +/- 1.6, 8.3 +/- 1.8, 10.5 +/- 1.6, and 10.3 +/- 1.3 cm H(2)O, respectively) for 95th percentile APAP, and pressures calculated by equations 1, 2, and 3, except between values calculated by equations 2and 3. Differences between the calculated and APAP-derived pressures were negative for the low calculated values, and were progressively attenuated, or became positive, for the high values. The differences were smallest for calculated pressures from 11 to > 13 cm H(2)O, which were represented to a greater extent among the values calculated by equations 2 and 3 than by those calculated by equation 1.

CONCLUSIONS

Considerably different therapeutic CPAP levels may be determined using various methods. The differences between the calculated and APAP-derived pressures are largest for calculated values of < 9 or > 15 cm H(2)O. The clinical consequences of these findings deserve further evaluation. Caution is still required before treating OSAS patients with calculated pressures.

摘要

背景

目前尚不清楚通过各种方法获得的用于治疗阻塞性睡眠呼吸暂停综合征（OSAS）的治疗性持续气道正压通气（CPAP）水平有多大差异。本研究旨在探讨自动CPAP（APAP）设备滴定的压力与使用不同预测方程计算的压力之间的关系，并比较计算压力的不同范围与APAP滴定的压力值。

方法

在140例OSAS患者中，比较了多导睡眠图期间APAP设备（AutoSet T；瑞思迈公司；悉尼，新南威尔士州，澳大利亚）输送的第95百分位数压力，以及由三个方程（方程1，霍夫斯坦和米尔耶蒂格[1994年]；方程2，塞里耶斯等人[2000年]；方程3，斯特拉德林等人[2004年]）计算的压力。

结果

滴定压力与计算压力之间呈弱相关。第95百分位数APAP的平均（±标准差）压力（分别为11.1±1.6、8.3±1.8、10.5±1.6和10.3±1.3 cm H₂O）与方程1、2和3计算的压力之间存在显著差异，但方程2和3计算的值之间除外。计算压力与APAP得出的压力之间的差异对于低计算值为负，对于高值逐渐减弱或变为正。对于11至>13 cm H₂O的计算压力，差异最小，方程2和3计算的值比方程1计算的值在更大程度上代表了这些压力。