Chen Chongxiang, Wen Tianmeng, Liao Wei
Department of Intensive Care Unit, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China.
School of Public Health, Sun Yat-sen University, Guangzhou 510060, China.
Ann Transl Med. 2019 Jul;7(14):337. doi: 10.21037/atm.2019.06.72.
Sleep apnea probably brings poor outcomes of chronic heart failure (CHF), and some methods show benefit to patients with heart failure (HF) and central sleep apnea (CSA). Our study based on the randomized controlled trials (RCTs) to find out the most beneficial therapy of nocturnal support to decrease the apnea hypopnea index (AHI).
The PubMed, and the Web of Science were used to find out the included studies. RevMan 5.3 and Stata 15.1 were performed to this systemic review and network meta-analysis.
After searching and screening the articles, finally we included 14 articles with total 919 patients, and 4 arms [adaptive servo ventilation (ASV), continuous positive airway pressure (CPAP), oxygen treatment, control]. Compared with the control group, the therapeutic regimens did not show significant difference in AHI. Ranking the different nocturnal supports in the order of estimated probabilities of each treatment by using the network meta-analysis, the result showed that ASV was the best one (87.8%), followed by oxygen (12.2%), CPAP (0%), and control (0%).
Based on our study, the adoptive servo ventilation is probably the best choice to down the AHI in patients with HF and CSA.
睡眠呼吸暂停可能导致慢性心力衰竭（CHF）预后不良，一些方法对心力衰竭（HF）合并中枢性睡眠呼吸暂停（CSA）患者有益。我们的研究基于随机对照试验（RCT），以找出夜间支持的最有益治疗方法，以降低呼吸暂停低通气指数（AHI）。
使用PubMed和科学网查找纳入研究。使用RevMan 5.3和Stata 15.1进行该系统评价和网络荟萃分析。
在检索和筛选文章后，最终我们纳入了14篇文章，共919例患者，以及4种干预措施[适应性伺服通气（ASV）、持续气道正压通气（CPAP）、氧疗、对照]。与对照组相比，治疗方案在AHI方面未显示出显著差异。通过网络荟萃分析按每种治疗的估计概率对不同的夜间支持进行排序，结果显示ASV是最佳选择（87.8%），其次是氧疗（12.2%）、CPAP（0%）和对照（0%）。
基于我们的研究，适应性伺服通气可能是降低HF合并CSA患者AHI的最佳选择。
