Efficacy of adaptive-servo ventilation (HEART PAP™) for an elderly patient with chronic heart failure who had Cheyne–Stokes respiration with central sleep apnea
| Autor: | Akira Yamashina, Hirokazu Saruhara, Kota Kato, Kazuki Shiina, Yoshifumi Takata, Yuki Hashimura, Yasuhiro Usui, Kihiro Asano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Central sleep apnea medicine.diagnostic_test business.industry Sleep apnea Adaptive-servo ventilation Apnea Atrial fibrillation Dilated cardiomyopathy Polysomnography medicine.disease Cheyne–Stokes respiration Article respiratory tract diseases Cheyne–Stokes respiration with central sleep apnea Internal medicine Heart failure Anesthesia medicine Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Popis: | Summary An 82-year-old male patient, who had been diagnosed with chronic heart failure due to dilated cardiomyopathy and combined valvular disease and who had atrial fibrillation with complete atrioventricular block, was admitted to our hospital owing to the exacerbation of chronic heart failure. During admission, the patient became aware of drowsiness during daytime hours and had periodic apnea during sleep. Polysomnography (PSG) revealed Cheyne–Stokes respiration with severe central sleep apnea as evidenced by an apnea–hypopnea index (AHI) of 93.5/h. Nocturnal oxygen therapy failed to sufficiently suppress apnea, and arousal reactions occurred frequently. Therefore, we conducted titration by adaptive-servo ventilation (ASV; HEART PAP™). Consequently, subjective symptoms and respiratory sleep parameters improved. The patient showed excellent adherence to loading the device at home. PSG at 3 months after implementation of HEART PAP™ indicated improvement in the AHI to 13.5/h, and the patient exhibited marked improvements in breathlessness and awareness of drowsiness during daytime hours. HEART PAP™ was found to be a useful device for Cheyne–Stokes respiration with central sleep apnea that is associated with chronic heart failure even for very elderly patients. |
| Databáze: | OpenAIRE |
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