What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study)
Abstract Backgrounds As a consequence of the increased mortality observed in the SERVE-HF study, many questions concerning the safety and rational use of ASV in other indications emerged. The aim of this study was to describe the clinical characteristics of ASV-treated patients in real-life conditio...
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| Format: | Article |
| Language: | English |
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BMC
2019-10-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-019-1221-9 |
| _version_ | 1818192517937496064 |
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| author | Dany Jaffuel Carole Philippe Claudio Rabec Jean-Pierre Mallet Marjolaine Georges Stefania Redolfi Alain Palot Carey M. Suehs Erika Nogue Nicolas Molinari Arnaud Bourdin |
| author_facet | Dany Jaffuel Carole Philippe Claudio Rabec Jean-Pierre Mallet Marjolaine Georges Stefania Redolfi Alain Palot Carey M. Suehs Erika Nogue Nicolas Molinari Arnaud Bourdin |
| author_sort | Dany Jaffuel |
| collection | DOAJ |
| description | Abstract Backgrounds As a consequence of the increased mortality observed in the SERVE-HF study, many questions concerning the safety and rational use of ASV in other indications emerged. The aim of this study was to describe the clinical characteristics of ASV-treated patients in real-life conditions. Methods The OTRLASV-study is a prospective, 5-centre study including patients who underwent ASV-treatment for at least 1 year. Patients were consecutively included in the study during the annual visit imposed for ASV-reimbursement renewal. Results 177/214 patients were analysed (87.57% male) with a median (IQ25–75) age of 71 (65–77) years, an ASV-treatment duration of 2.88 (1.76–4.96) years, an ASV-usage of 6.52 (5.13–7.65) hours/day, and 54.8% were previously treated via continuous positive airway pressure (CPAP). The median Epworth Scale Score decreased from 10 (6–13.5) to 6 (3–9) (p < 0.001) with ASV-therapy, the apnea-hypopnea-index decreased from 50 (38–62)/h to a residual device index of 1.9 (0.7–3.8)/h (p < 0.001). The majority of patients were classified in a Central-Sleep-Apnea group (CSA; 59.3%), whereas the remaining are divided into an Obstructive-Sleep-Apnea group (OSA; 20.3%) and a Treatment-Emergent-Central-Sleep-Apnea group (TECSA; 20.3%). The Left Ventricular Ejection Fraction (LVEF) was > 45% in 92.7% of patients. Associated comorbidities/etiologies were cardiac in nature for 75.7% of patients (neurological for 12.4%, renal for 4.5%, opioid-treatment for 3.4%). 9.6% had idiopathic central-sleep-apnea. 6.2% of the patients were hospitalized the year preceding the study for cardiological reasons. In the 6 months preceding inclusion, night monitoring (i.e. polygraphy or oximetry during ASV usage) was performed in 34.4% of patients, 25.9% of whom required a subsequent setting change. According to multivariable, logistic regression, the variables that were independently associated with poor adherence (ASV-usage ≤4 h in duration) were TECSA group versus CSA group (p = 0.010), a higher Epworth score (p = 0.019) and lack of a night monitoring in the last 6 months (p < 0.05). Conclusions In real-life conditions, ASV-treatment is often associated with high cardiac comorbidities and high compliance. Future research should assess how regular night monitoring may optimize devices settings and patient management. Trial registration The OTRLASV study is registered on ClinicalTrials.gov (Identifier: NCT02429986) on 1 April 2015. |
| first_indexed | 2024-12-12T00:31:46Z |
| format | Article |
| id | doaj.art-05b8b1a12e834ae2acbede9b93ac94bd |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-12T00:31:46Z |
| publishDate | 2019-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-05b8b1a12e834ae2acbede9b93ac94bd2022-12-22T00:44:28ZengBMCRespiratory Research1465-993X2019-10-0120111410.1186/s12931-019-1221-9What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study)Dany Jaffuel0Carole Philippe1Claudio Rabec2Jean-Pierre Mallet3Marjolaine Georges4Stefania Redolfi5Alain Palot6Carey M. Suehs7Erika Nogue8Nicolas Molinari9Arnaud Bourdin10Department of Respiratory Diseases, Montpellier University Hospital, Hôpital Arnaud de VilleneuveCentre des pathologies du sommeil, Hôpital Universitaire de la Pitié Salpêtrière, AP-HPPulmonary Department and Respiratory Critical Care Unit, University Hospital DijonDepartment of Respiratory Diseases, Montpellier University Hospital, Hôpital Arnaud de VilleneuvePulmonary Department and Respiratory Critical Care Unit, University Hospital DijonCentre des pathologies du sommeil, Hôpital Universitaire de la Pitié Salpêtrière, AP-HPClinique des Bronches, Allergies et du Sommeil, Assistance Publique Hôpitaux de MarseilleDepartment of Respiratory Diseases, Montpellier University Hospital, Hôpital Arnaud de VilleneuveClinical Research and Epidemiology Unit (URCE), Montpellier University HospitalDepartment of Medical Information, Montpellier University HospitalDepartment of Respiratory Diseases, Montpellier University Hospital, Hôpital Arnaud de VilleneuveAbstract Backgrounds As a consequence of the increased mortality observed in the SERVE-HF study, many questions concerning the safety and rational use of ASV in other indications emerged. The aim of this study was to describe the clinical characteristics of ASV-treated patients in real-life conditions. Methods The OTRLASV-study is a prospective, 5-centre study including patients who underwent ASV-treatment for at least 1 year. Patients were consecutively included in the study during the annual visit imposed for ASV-reimbursement renewal. Results 177/214 patients were analysed (87.57% male) with a median (IQ25–75) age of 71 (65–77) years, an ASV-treatment duration of 2.88 (1.76–4.96) years, an ASV-usage of 6.52 (5.13–7.65) hours/day, and 54.8% were previously treated via continuous positive airway pressure (CPAP). The median Epworth Scale Score decreased from 10 (6–13.5) to 6 (3–9) (p < 0.001) with ASV-therapy, the apnea-hypopnea-index decreased from 50 (38–62)/h to a residual device index of 1.9 (0.7–3.8)/h (p < 0.001). The majority of patients were classified in a Central-Sleep-Apnea group (CSA; 59.3%), whereas the remaining are divided into an Obstructive-Sleep-Apnea group (OSA; 20.3%) and a Treatment-Emergent-Central-Sleep-Apnea group (TECSA; 20.3%). The Left Ventricular Ejection Fraction (LVEF) was > 45% in 92.7% of patients. Associated comorbidities/etiologies were cardiac in nature for 75.7% of patients (neurological for 12.4%, renal for 4.5%, opioid-treatment for 3.4%). 9.6% had idiopathic central-sleep-apnea. 6.2% of the patients were hospitalized the year preceding the study for cardiological reasons. In the 6 months preceding inclusion, night monitoring (i.e. polygraphy or oximetry during ASV usage) was performed in 34.4% of patients, 25.9% of whom required a subsequent setting change. According to multivariable, logistic regression, the variables that were independently associated with poor adherence (ASV-usage ≤4 h in duration) were TECSA group versus CSA group (p = 0.010), a higher Epworth score (p = 0.019) and lack of a night monitoring in the last 6 months (p < 0.05). Conclusions In real-life conditions, ASV-treatment is often associated with high cardiac comorbidities and high compliance. Future research should assess how regular night monitoring may optimize devices settings and patient management. Trial registration The OTRLASV study is registered on ClinicalTrials.gov (Identifier: NCT02429986) on 1 April 2015.http://link.springer.com/article/10.1186/s12931-019-1221-9Adaptive servo-ventilationCentral sleep apneaChronic heart failureCPAPObstructive sleep apneaTreatment emergent central sleep apnea |
| spellingShingle | Dany Jaffuel Carole Philippe Claudio Rabec Jean-Pierre Mallet Marjolaine Georges Stefania Redolfi Alain Palot Carey M. Suehs Erika Nogue Nicolas Molinari Arnaud Bourdin What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) Respiratory Research Adaptive servo-ventilation Central sleep apnea Chronic heart failure CPAP Obstructive sleep apnea Treatment emergent central sleep apnea |
| title | What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) |
| title_full | What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) |
| title_fullStr | What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) |
| title_full_unstemmed | What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) |
| title_short | What is the remaining status of adaptive servo-ventilation? The results of a real-life multicenter study (OTRLASV-study) |
| title_sort | what is the remaining status of adaptive servo ventilation the results of a real life multicenter study otrlasv study |
| topic | Adaptive servo-ventilation Central sleep apnea Chronic heart failure CPAP Obstructive sleep apnea Treatment emergent central sleep apnea |
| url | http://link.springer.com/article/10.1186/s12931-019-1221-9 |
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