Efficacy of bilevel ventilatory support in the treatment of stable patients with obesity hypoventilation syndrome: systematic review and meta-analysis
| Autor: | Claudia Schweiger, Vinicius André Guerra, Luisi Rabaioli, Denise Manica, Caroline Persch Royer, Graciele Sbruzzi |
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| Rok vydání: | 2019 |
| Předmět: |
Obesity hypoventilation syndrome
medicine.medical_specialty business.industry medicine.medical_treatment MEDLINE General Medicine medicine.disease law.invention 03 medical and health sciences 0302 clinical medicine 030228 respiratory system Randomized controlled trial law Meta-analysis Internal medicine Positive airway pressure medicine In patient Continuous positive airway pressure business 030217 neurology & neurosurgery Oxygen saturation (medicine) |
| Zdroj: | Sleep Medicine. 53:153-164 |
| ISSN: | 1389-9457 |
| DOI: | 10.1016/j.sleep.2018.09.016 |
| Popis: | Objective To systematically review the effects of bilevel ventilatory support (BVS) in patients with Obesity Hypoventilation Syndrome (OHS). Methods A search of databases (MEDLINE accessed by PubMed, Cochrane CENTRAL, EMBASE and LILACS) was conducted from inception to June 2018. Randomized trials comparing BVS to other therapeutic modalities such as lifestyle counseling, continuous positive airway pressure (PAP) or BVS with average volume assured pressure support for the treatment of patients with OHS were included. The primary outcome was a change in daytime arterial carbon dioxide levels (PaCO2). Secondary outcome measures included arterial partial pressure of oxygen (PaO2), blood bicarbonate (HCO3), percentage of total sleep time (TST) with oxygen saturation Results Of 176 articles identified, seven studies were included. When BVS was compared to lifestyle counseling, the intervention was superior in improving PaCO2 (−2.90 mmHg; 95%CI −4.28 to −1.52), PaO2 (2.89 mmHg; 95%CI 0.33 to 5.46), HCO3 (−2.55 mmol/L; 95%CI −3.28 to −1.81), percentage of TST Conclusions Treatment using BVS therapy is superior to lifestyle counseling. Different PAP modalities appear to be equally effective in improving outcomes. CRD42017065326. |
| Databáze: | OpenAIRE |
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