Impact of different backup respiratory rates on the efficacy of noninvasive positive pressure ventilation in obesity hypoventilation syndrome: a randomized trial

Chest
Olivier ContalJean-Paul Janssens

Abstract

Unintentional leaks, patient-ventilatory asynchrony, and obstructive or central events (either residual or induced by noninvasive positive pressure ventilation [NPPV]) occur in patients treated with NPPV, but the impact of ventilator settings on these disturbances has been little explored. The objective of this study was to investigate the impact of backup respiratory rate (BURR) settings on the efficacy of ventilation, sleep structure, subjective sleep quality, and respiratory events in a group of patients with obesity hypoventilation syndrome (OHS). Ten stable patients with OHS treated with long-term nocturnal NPPV underwent polysomnographic recordings and transcutaneous capnography on 3 consecutive nights with three different settings for BURR in random order: spontaneous (S) mode, low BURR, and high BURR. No other ventilator parameter was modified. The S mode was associated with the occurrence of a highly significant increase in respiratory events, mainly of central and mixed origin, when compared with both spontaneous/timed (S/T) modes. Accordingly, the oxygen desaturation index was significantly higher in the S mode than in either of the S/T modes. The results of nocturnal transcutaneous P(CO(2)) (Ptc(CO(2))) (mean value ...Continue Reading

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Citations

Oct 25, 2012·Pulmonary Medicine·Arijit ChandaConstantine A Manthous
Nov 22, 2013·Respiratory Research·Johan Verbraecken, Walter T McNicholas
Dec 10, 2013·Respiratory Physiology & Neurobiology·Louis MayaudFrédéric Lofaso
Apr 3, 2013·Chest·Olivier ContalJean-Paul Janssens
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