Pengo Martino F, Bonafini Sara, Fava Cristiano, Steier Joerg
King's College London, Faculty of Life Sciences and Medicine, London, UK.
Guy's and St Thomas' NHS Foundation Trust, Lane Fox Respiratory Unit/Sleep Disorders Centre, London, UK.
J Thorac Dis. 2018 Jan;10(Suppl 1):S57-S70. doi: 10.21037/jtd.2018.01.39.
The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage. CPAP can alter long-term cardiovascular risk in patients with cardiorespiratory conditions. Furthermore, the effect of CPAP on the awake patient differs from the effect on the patients while asleep, and this might contribute to discomfort and removal of the use interface. The purpose of this review is to highlight the physiological impact of CPAP on the cardiorespiratory system, including short-term benefits and long-term outcomes.
阻塞性睡眠呼吸暂停(OSA)的首选治疗方法是持续气道正压通气治疗(CPAP)。自CPAP引入临床实践以来,它已被用于各种临床情况,但其结果各不相同且存在异质性。除了对上呼吸道的众所周知的影响外,CPAP还会影响胸内压力、血流动力学和血压(BP)控制。然而,CPAP治疗的短期和长期效果取决于多个变量,包括症状、基础疾病、使用的压力、治疗接受度、依从性和使用情况。CPAP可以改变心肺疾病患者的长期心血管风险。此外,CPAP对清醒患者的影响与对睡眠患者的影响不同,这可能导致不适并促使患者移除使用界面。本综述的目的是强调CPAP对心肺系统的生理影响,包括短期益处和长期结果。