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Nasal versus oronasal mask in patients under auto-adjusting continuous positive airway pressure titration: a real-life study.
Duarte, Ricardo L M; Mendes, Bruno A; Oliveira-E-Sá, Tiago S; Magalhães-da-Silveira, Flavio J; Gozal, David.
Afiliação
  • Duarte RLM; SleepLab, Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Avenida das Américas 4666, sala 309, Barra da Tijuca, Rio de Janeiro, 22649-900, Brazil. rlmduarte@gmail.com.
  • Mendes BA; Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. rlmduarte@gmail.com.
  • Oliveira-E-Sá TS; Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
  • Magalhães-da-Silveira FJ; Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal.
  • Gozal D; NOVA Medical School, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.
Eur Arch Otorhinolaryngol ; 277(12): 3507-3512, 2020 Dec.
Article em En | MEDLINE | ID: mdl-32725272
PURPOSE: Mask type (nasal versus oronasal) can affect the optimal pressure required to correct the apnea/hypopnea index (AHI) in obstructive sleep apnea (OSA) subjects treated with CPAP. Our objective was to evaluate if mask type influenced CPAP titration outcomes in OSA patients. METHODS: A retrospective study of individuals with a baseline AHI ≥ 15.0/h, who received an auto-adjusting CPAP titrating device (S9 AutoSet ResMed®) in a sleep-lab setting. The mask type oronasal (OM) or nasal (NM) was always selected by the patients. Optimal pressure requirements, leak, and residual AHI were compared based on mask type. RESULTS: Overall, 436 patients were included: 283 with NM (64.9%) and 153 with OM (35.1%). At baseline, NM and OM cohorts had similar AHI (p = 0.160). Patients allocated to the OM cohort had a higher 95th percentile pressure, a higher 95th percentile leak, and a higher residual AHI than those with a NM: pressure requirement: 12.9 cm H2O (IQR: 10.6-15.0) versus 10.7 cm H2O (IQR: 9.2-12.3); leak: 21.6 L/min (IQR: 9.6-37.2) versus 9.6 L/min (IQR: 3.6-19.2); and residual AHI: 4.9/h (IQR: 2.4-10.2) versus 2.2/h (IQR: 1.0-4.4), respectively (p < 0.001 for all). CONCLUSIONS: CPAP mask type based on individual preferences exerts profound effects on optimal CPAP pressures and efficacy. Patients titrated with OM showed higher pressure requirements, had higher a leak, and higher residual AHI when compared to NM, which may adversely impact treatment adherence and other health outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
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XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apneia Obstrutiva do Sono / Pressão Positiva Contínua nas Vias Aéreas Tipo de estudo: Observational_studies Limite: Humans Idioma: En Revista: Eur Arch Otorhinolaryngol Assunto da revista: OTORRINOLARINGOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha