Nasal vs Oronasal CPAP for OSA Treatment
| Autor: | Pedro R. Genta, Fernanda Madeiro Leite Viana, Luciano F. Drager, Andre R. Brunoni, Adriano H. Moffa, Juliana Nascimento, Geraldo Lorenzi-Filho, Rafaela G.S. Andrade |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry Gold standard MEDLINE Sleep apnea Critical Care and Intensive Care Medicine medicine.disease Cpap adherence Pressure level nervous system diseases respiratory tract diseases Newcastle–Ottawa scale 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Apnea–hypopnea index Meta-analysis Internal medicine medicine Cardiology and Cardiovascular Medicine business therapeutics 030217 neurology & neurosurgery |
| Zdroj: | Chest. 153:665-674 |
| ISSN: | 0012-3692 |
| Popis: | Background Nasal CPAP is the "gold standard" treatment for OSA. However, oronasal masks are frequently used in clinical practice. The aim of this study was to perform a meta-analysis of all randomized and nonrandomized trials that compared nasal vs oronasal masks on CPAP level, residual apnea-hypopnea index (AHI), and CPAP adherence to treat OSA. Methods The Cochrane Central Register of Controlled Trials, Medline, and Web of Science were searched for relevant studies in any language with the following terms: "sleep apnea" and "CPAP" or "sleep apnea" and "oronasal mask" or "OSA" and "oronasal CPAP" or "oronasal mask" and "adherence." Studies on CPAP treatment for OSA were included, based on the following criteria: (1) original article; (2) randomized or nonrandomized trials; and (3) comparison between nasal and oronasal CPAP including pressure level, and/or residual AHI, and/or CPAP adherence. Results We identified five randomized and eight nonrandomized trials (4,563 patients) that reported CPAP level and/or residual AHI and/or CPAP adherence. Overall, the random-effects meta-analysis revealed that as compared with nasal, oronasal masks were associated with a significantly higher CPAP level (Hedges' g, –0.59; 95% CI, –0.82 to –0.37; P Conclusions Oronasal masks are associated with a higher CPAP level, higher residual AHI, and poorer adherence than nasal masks. Trial Registry PROSPERO database; No.: CRD42017064584; URL: https://www.crd.york.ac.uk/prospero/. |
| Databáze: | OpenAIRE |
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