Weiss Pnina, Kryger Meir
Pediatric Respiratory Medicine and Medical Education, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
Pulmonary, Critical Care and Sleep Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
Otolaryngol Clin North Am. 2016 Dec;49(6):1331-1341. doi: 10.1016/j.otc.2016.07.004. Epub 2016 Oct 6.
Positive airway pressure (PAP) is considered first-line therapy for moderate to severe obstructive sleep apnea and may also be considered for mild obstructive sleep apnea, particularly if it is symptomatic or there are concomitant cardiovascular disorders. Continuous PAP is most commonly used. Other modes, such as bilevel airway pressure, autotitrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation, play important roles in the management of sleep-related breathing disorders. This article outlines the indications, description, and comfort features of each mode. Despite the proven efficacy of PAP in treating obstructive sleep apnea syndrome and its sequelae, adherence to therapy is low. Close follow-up of patients for evaluation of adherence to and effectiveness of treatment is important.
气道正压通气(PAP)被视为中重度阻塞性睡眠呼吸暂停的一线治疗方法,对于轻度阻塞性睡眠呼吸暂停也可考虑使用,特别是当它有症状或伴有心血管疾病时。持续气道正压通气(CPAP)是最常用的。其他模式,如双水平气道正压通气、自动调压气道正压通气、平均容量保证压力支持通气和适应性支持通气,在睡眠相关呼吸障碍的管理中发挥着重要作用。本文概述了每种模式的适应症、描述和舒适性特点。尽管PAP在治疗阻塞性睡眠呼吸暂停综合征及其后遗症方面的疗效已得到证实,但治疗依从性较低。对患者进行密切随访以评估治疗依从性和有效性很重要。